眼窩涙腺腺様嚢胞癌3例の検討

Three cases of the orbital adenoid cystic carcinoma

　涙腺腺様嚢胞癌の3例を外科的に治療した。初診時の年齢は，それぞれ29,46,53歳であった。2例は死の転帰をとった。次のような共通した所見があった。本症は他の良性腺腫と鑑別がしばしば困難である。その増殖は，周囲組織に浸潤していくことが多いが，その速度は比較的遅い。しかし，ひとたび手術侵襲などが加わると，旺盛な増殖が始まり，解剖学的な位置関係から，眼窩骨壁に浸潤しやすい。最終的には，血行性に頭蓋内，肺，骨に転移する。以上のような理由から，涙腺腺様嚢胞癌の診断が確定した時点で，眼窩内容除去術や眼窩骨切り術を含んだ拡大腫瘍切除術を選択するべきである。

We surgically treated three cases of adenoid cystic carcinoma originating from the lacrimal gland. The patients were aged 29, 46 and 53 years when first seen by us. Death resulted in two cases. The cases showed following features in common. The condition was sometimes difficult to differentiate from other benign orbital adenoma. Regarding its growth pattern, adenoid cystic carcinoma often showed slow infiltration into the surrounding tissue. After surgical invasion, the tumor growed vigorously and was likely to involve the orbital wall in most cases because of its anatomical location. The tumor ultimately metastat-ized to the head, lung and bone. Becuse of these features, we advocate extensive resection of the tumor including total removal of orbital content and orbital osteotomy once the diagnosis of adenoid cystic carcinoma is established.