聴器悪性腫瘍—当科における10年間の症例について

MALIGNANT TUMORS OF THE EAR

　I．はじめに

　聴器に発生する悪性腫瘍はきわめてまれであり，とくに中耳の悪性腫瘍症例は腫瘍発生部位の解剖学的な特殊性および早期発見が遅れ治療が困難な点より予後が悪いことで知られている。最近10年間に私どもは17例の聴器悪性腫瘍を経験した。ここに症例の一部をとりあげ，国内外の諸文献と比較しつつ症例の統計的観察を行ない，いくつかの観点につき知見を得たので報告する。

　Malignant tumors that originate from the ear are rare. In our clinic during the recent 10years only 17 cases of such tumors have been treated, making the incidence of 1 in 4,000 cases of otolaryngological patients.

　As to their origin, 10 cases were derived from the external auditory canal and the remaining 7 from the middle ear. Histological features were that squamous cell carcinoma comparised 53% and there were only 4 cases of adenocystic carcinoma, one of which was attributed to originating from the middle ear.

　There were histories of previous ear surgery in 4 out of 5 cancers of the middle ear, and a possible etiological relationship that might exist between these two facts are discussed.

　Symptoms of malignant tumors of the ear not specifically different from those of chronic inflammatory diseases of the ear. The treatments of the malignancy of the ear is either irradiation or surgery. In view of the facts that there are anatomical difficulties and limitations to perform radical surgery, it is deemed the most important to make a close observation of the patients, enabling local recurrences amenable to an early detection and treatment.

　In spite of the active treatment as stated above, the prognosis is not so good, particularly in cases of squamous cell carcinoma.

　Special comments are made concerning 2 cases of osteosarcoma which progressed rather slowly, and a case of squamous cell carcinoma that showed an unusual clinical features.