上顎癌の頭蓋内浸潤経路についての一考察—神経行性浸潤の可能性

POSSIBILITY OF TRANSNEURAL INVASION OF TUMOR OF MAXILLARY SINUS TO INTRACRANIAL SPACE

　I．はじめに

　癌の転移，浸潤経路としては，主に血行性，リンパ行性，播種性，そして組織間隙に沿って，あるいは腫瘍自体の増大による他臓器への直接浸潤などが言われてきた。今回，上顎癌の頭蓋内への浸潤を認めた例で，手術および剖検による所見より神経行性の浸潤が示唆されたので，参考に供したい。

　In a patient of carcinoma of maxillary sinus who was operated after irradiation and infusion of bleomycin, the maxillary branch of the trigeminal nerve in the pterygoid fossa was examined histologscally. Tumor cells were observed in the nerve, and this finding suggested the invasion of tumor into the intracranial space via this nerve. The patient died due to recurrence and invasion into the brain 2 years after first admission. Autopsy revealed that invasive tumor mass was recognized at the middle fossa, and tumor cells were observed in the intracranial part of the trigeminal nerve. Possibility of transneural invasion of tumors of head and neck was discussed.