上顎真性癌肉腫

A Case of Carcinosarcoma of the Maxillary Sinus

I．はじめに

　上皮性悪性腫瘍である癌腫と非上皮性悪性腫瘍である肉腫とが，同時に同一器官に発生する真性癌肉腫は極めて稀とされている。耳鼻咽喉科領域では，喉頭に発生した癌肉腫の報告が散見されるが，上顎洞発生例の報告は極めて少なく，現在までに5例^1〜5）の報告を見るに過ぎない。癌肉腫の概念およびhistogenesisについては従来多くの論議があり，現在なお結論は得られていない点もあるが，最近我々は真性の上顎洞癌肉腫例を経験したので，症例の報告とともに本腫瘍に関する文献的考察を行ってみたい。

　A very rare case of carcinosarcoma of the maxillary sinus was reported, and this report seems to be the fifth one in the literature of the world. A 60-year-old man with a tumor of the right maxillary sinus was treated by irradiation, chemotherapy and total maxillectomy. However these treatments could not control a rapid growth of the tumor, and he died of metastasis to the brain, bilateral lungs, pleurae and diaphragma. Histopathological examinations of the maxillary tumor revealed that it consisted of two malignant elements ; squamous cell carcinoma and osteosarcoma. Though carcinomatous lesion became smaller by irradiation and chemotherapy, sarcomatous lesion including metastasis grew rapidly. The current method of treatment for maxillary carcinosarcoma seems to be surgical, based on the early diagnosis of carcinosarcoma rather than conservative.