副鼻腔原発の粘液型悪性線維性組織球腫の1症例

A Case of Malignant Fibrous Histiocytoma in the Maxillary and Ethmoid Sinuses

I．はじめに

　悪性線維性組織球腫malignant fibrous histiocytomaは中高齢者ではもっとも頻度の高い軟部組織肉腫である。四肢，体幹，後腹膜腔の軟部組織に好発するが頭頸部領域での発生も稀ではなく，その大部分は副鼻腔原発のものである。組織学的に5型に分類されるが，とくに粘液型（myxoid）悪性線維性組織球腫は粘液型脂肪肉腫myxoid liposarcomaなどの肉腫，粘液腫や結節性筋膜炎などの良性病変との鑑別が問題になることが多い。今回われわれは右上顎洞，篩骨洞にかけて原発し再発を繰り返した粘液型悪性線維性組織球腫の1症例を経験したので，その臨床所見および病理学的所見に若干の文献的考察を加えて報告する。

　A 55-year-old woman was admitted because ofright cheek swelling and pain. She had undergone Caldwell-Luc operation at 32 years of age. Before she came to our hospital, she had experienced tumor resection three times elsewhere, and recurrence was noted each time. Rediological examinations showed an extensive bony destruction and an expansive mass lesion in the maxillary and ethmoid sinuses.

　Malignant sarcoma was suspected, and radical surgery and radiochemotherapy were performed. Histological examination revealed a mixed type malignant fibrous histiocytoma of the maxillary sinus.

　The clinical course and prognosis in this case were described, and the literature was reviewed and discussed.