脳転移をきたした肺carcinosarcomaの1例

CARCINOSARCOMA OF THE LUNG

I．はじめに

　Carclnosarcomaは，悪性腫瘍のなかでもまれな疾患の一つである。子宮，乳腺，食道，上気道など原発のcar—cinosarcomaは，しばしば報告されている。しかし，肺carcinosarcomaの報告例はきわめて少ない。その第1例である貴家（1908）^12）の報告以来現在までに，十数例を数えるにすぎない。一方，術前，あるいは生前に，肺carcinosarcmaの診断が確定することはむずかしいことである。現在までの報告例はすべて剖検あるいは手術後の組織学的検査により確診されたものである。

　最近，われわれは，脳圧亢進を初発症状とした，肺carcinosarcomaの脳転移症例を経験し，剖検する機会を得たので報告するとともに文献的考察を加えた。

Pulmonary carcinosarcoma in quite rarely encoun-tered in the literature and we recently experienced a case of the brain metastasis primarily originated in the right lower lobe. The patient was a 75-year-old male who underwent the angiography because of his severe headache and vertigo of two and a half months duration. Clinical and angiographical examination indicated a right posterior fossa space taking lesion. Because of his critical conditions, patient was treated conservatively and expired due to the intracranial hypertention.

Autopsy revealed 1. 7×1.2×1.5 cm nodule in the left lateral aspect of thalamus and 5.5×3.5×3.5 cm nodule in the right hemisphere of the cerebellum. Also in the right lower lobe of the lung, gray in-filtrative highly necrotized mass of 6 cm in diameter was found. The pathology of the pulmonary mass was proved to be a carcinosarcoma intermingled with adenocarcinomatous and fibrosarcomatous com-ponents. The masses found in the supra- and infra-tentorium of the brain were verified pathologically only to be carcinomatous in the component.