Garcin症候群を呈した中耳癌症例の側頭骨病理所見

Temporal Bone Pathology of Middle Ear Cancer Manifesting Garcin Syndrome

はじめに

　側頭骨に発生する癌種は，頭頸部領域の腫瘍のなかでもまれなものであり，その早期発見は困難なことが多く，予後不良の疾患である。治療法は，未だ十分に確立されていないため，腫瘍の原発部位と浸潤の様式を病理学的に知ることが，今後の治療法を立案するうえで重要であると考えられる。

　今回われわれは，外耳道，中耳，乳突蜂巣と広範に浸潤し，Garcin症候群を呈した扁平上皮癌症例を経験したので，本症例の側頭骨病理を中心に報告する。

Temporal bone pathology of a woman who died of intracranial invasion of middle ear cancer was studied. She complained of right otalgia, otorrhea and hearing impairment followed by right facial palsy when she was 39 years old. The specimen taken from the right mastoid at surgery demon-strated squamous cell cancer. Although she was given radiation therapy and chemotherapy, she manifested right Garcin syndrome and died of central respiratory arrest. The postmortem survey revealed the intracranial invasion of the middle ear cancer. Meantime, the temporal bone study disclosed invasion of middle ear cancer in the mastoid cells and the internal auditory canal but no cancer cells in the inner ear. These findings suggest that middle ear cancer could cause Garcin syndrome following after invasion and destruction of cancer from the middle ear to mastoid and internal auditory canal.