外耳道癌の3症例

CARCINOMA OF THE EXTERNAL AUDITORY MEATUS

　I．緒言

　一般に聴器に発生する癌腫は稀なもので，Bezold^1）は2000人の患者中，4人の聴器悪性腫瘍をみたと報告している。最近，Conley^2）は1945年から1972年までの27年間に273例の耳悪性腫瘍中，耳介悪性腫瘍は187例，外耳道に原発した悪性腫瘍は61例，中耳悪性腫瘍は25例あつたと報告していることからも，聴器悪性腫瘍の中で外耳道に原発する悪性腫瘍は非常に少ないことがわかる。さきにわが教室の馬場らはここ10年間に4例の中耳癌を報告した。さらにわれわれはこの10年間に3例の外耳道癌を経験したので追加報告する。

　第1例は肺癌から右外耳道への転移癌，第2例は右外耳道に原発した腺癌，第3例は左外耳道に原発した扁平上皮癌の症例である。

　The malignant tumor involving the external auditory canal is rarely met with. The authors are presenting 3 cases of cancer of this regionF. , one of metastatic and two primary cancers.

　Case 1. A 60-year-old man was admitted to theauthors'hospital on May 4, 1967. About 3 months before admission the patient was treated for hemoptysis and coungh following a common cold. Upon x-ray examination signs of obstructive atelectasis was found in the upper lobe of the left lung. Tubercle bacilli were positive in the sputum. Diagnosis of lung tuberculosis was made, and the patient was placed under chemotherapy. One month after admission bronchoscopic brushing cytology revealed a grade 5 infection. There was a slight enlargement of the lymph node on the left side of the neck.

　On July 25, 1967, a mass was discovered in the right auditory canal. Three weeks later the right ear was found to be what appeared to be a polyp. Biopsy of this mass showed evedence of anaplastic carcinoma.

　Case 2. A man, aged 20, was first seen on November 19, 1975. The patient complained a blockage of the left ear for a period of 1 year. Examination revealed a mass 1 cm in diameter block-in the left auditory canal meatus. Upon hospitalization the patient was operated upon for total excision of mass. Microscopic examination showedevidence of adenocarcinoma.

　Case 3. A 70-year-old man was admitted to our service with a complaint of slight deafness from his childhood. About one year before admission he was treated for otitis externa of the left ear. Since this occassion and for the last 6 months there had been drainage of pus and blood from this ear with continuous earache. Examination revealed a mass in the external canal of the left ear. Biopsy revealed a squamous carcinoma. X-ray revealed a tumor in the left external auditory without any appreciable bony destruction. The patient was given X-ray treatment the total of 4,200 rad. There-after the patient was operated upon. The growth in the external auditory canal was removed in one whole piece. A radical operation was performed for the treatment of the chronic otitis media. The tympanic membrane was largely removed and the posterior wall was taken down for excess to the antrum. The latter contained some granulation tissues but cholesteatoma was not found. Pathological examination of the removed material showed no malignancy.