脊髄症状を初発とした耳下腺癌症例

A MALIGNANT TUMOR OF THE PAROTID GLAND WITH METASTASIS INTO THE CERVICAL VERTEBRA

　I．はじめに

　今回われわれは脊髄症状を初発として整形外科に入院した耳下腺癌症例を経験した。その症状は非定型的であり，診断には困難をきわめ，最終的には試験切除をせざるを得なかつた。その後の経過も耳下腺腫瘍に関してはきわめて緩慢であり，脊椎転移による症状のみが徐々に悪化していつたという如き特徴ある経過をたどり，結局脊髄症状が発現してから1年2ヵ月後に肺転移の拡大によつて死亡した。

　本症例の，特に診断上の問題点につきご批判を仰ぐべく，ここに全経過を供覧することにした。また耳下腺腫瘍の遠隔転移につき文献的に考察したのでご参考に供したい。

　A man, aged 66, suffered a malignant tumor of the parotid gland. Backache, pains in the arms and the elbows were the first manifestation of the symptoms and the parotid gland swelling appeared 3 months thereafter. This was followed by a facial nerve paralysis 20 days later.

^99m Tc and ⁶⁷ Gascannings were applied to thewhole body. The parotid tumor was hypoactive to ^99mTc and hyperactive towards ⁶⁷Ga which appear to be the most characteristic findings in the case of malignant tumors. On the other hand there were abnormal accumulation of ^99mTc and ⁶⁷Ga in the metastasis of the cervical vertebra.

　Histological examination revealed the growth to be an adenocarcinoma.

　The patient was treated by administration of anticancer drug therapy and irradiation but he died a year later from metastatic pulmonary involvements.