頭蓋内に浸潤した篩骨洞癌の2例

Intracranial Invasion of Ethmoid Cancer : a Report of Two Cases

Ⅰ．はじめに

　副鼻腔原発癌は少なく，全悪性腫瘍中，0.2％の頻度とされている（Martin^13），Dodd et aL^2））．その中でも，副鼻腔の部位別にみると，篩骨洞癌は全副鼻腔癌の5.6％（Larsson et al^12）），5,5％（Hara^5）），6.5％（FitzHugh et al．^3）），33％（Osborn et al．^15）），と少なく，残りのほとんどが上顎癌である．

　わが国では，犬山ら^8）によると，上顎癌の比率がさらに高く，篩骨洞癌は全副鼻腔癌の2％で，総計しても34例の報告があるのみである．その内，頭蓋内へ浸潤したものは，わずか6例のみで，症例数の少なさのため臨床像に不明な所もある．最近，我々は，この篩骨洞癌の頭蓋内への浸潤例を2例経験したので，その詳細を報告し，文献的考察を加えて病態像を明らかにしたい．

Two cases of intracranial invasion of the ethmoid cancer were reported.

With additional six cases reported in Japan, the precise clinical course and pathophysiological findings of the disease were reviewed, and the following several points became clear;

1) The incidence of the ethmoid cancer was rare.

2) These were divided into two main groups according to the onset of intracranial signs, such as the frontal lobe symtoms and - VII cranial nerve involvement.

The first group showed the intracranial symptoms early, and the second group late.

3) The tumor invaded the cranial cavity along the perineural sheeth of each cranial nerve mainly.