副鼻腔の線維性骨性腫瘍および線維性異栄養症の肉腫化した症例

FIBRO-OSSEOUS NEOPLASM OF PARANASAL SINUSES AND FIBROUS DYSPLASIA OF THE MIXILLA COMPLICATED BY FIBROSARCOMA

　副鼻腔の線維性骨性腫瘍やいわゆる線維性異栄養症といわれるものは，さほど稀ではない。われおれも現在までに，上顎洞や前頭洞あるいは篩骨蜂窠に発生したこれらの疾患を5例経験したが，そのうちには，臨床的にも病理組織学的にもいろいろな様相を呈して，渉猟し得た文献^1）-31）を参照しても，比較的奇異と思われる例もあるので，経験例を発表するとともに，副鼻腔の線維性骨性腫瘍および線維性異栄養症について若干の考察を行なつてみたい。

　Five cases of neoplastic osseous involvements affecting the nasal sinuses are reported.

　The first case a boy, aged 14, was affected with a mixed-type osteoma of the left frontal and ethmoid sinuses. The second a man, aged 29, was found to be involved with an ossifying fibroma of the left frontal sinus. In both cases the lesions developed following a traumatic injury. Surgical removal of the growths was performed with a success. In the third a boy, aged 11, was found affected with an ossifying fibroma and the fourth a woman, aged 50, with fibro-osteoma. In both cases the lesion developed spontaneously and they were treated conservatively. No recurrence of the growth has been seen after 6 years for the former and 20 years for the latter.

　In the fifth case a woman, aged 33, who was affected with polyostotic fibrous dysplasia. The maxillary lesion, eventually developed a fibrosarcoma of this structure. The patient died. The former condition in this case was initially manifested in the left maxilla when the patient was five years old. After its dormancy for the period of 13 years the growth turned active involving the adjacent alveolar process with final degeneration into its terminal changes. No metastasis was found at the autopsy.

　The malignant transformation in the fifth case seems to have occurred after radiation therapy and cancer chemotherapy. The importance in distinguishing ordinary fibroosseous neoplasm from fibrous dysplasia and true malignant neoplasms of the paranasal was stressed.