急激な経過を辿つた耳下腺細網肉腫症例

RETICULUM CELL SARCOMA OF THE PAROTlD GLAND, A CASE REPORT

　I．はじめに

　耳下腺の腫大をきたす疾患は比較的多く，炎症，腫瘍などその病像も多様である。腫瘍では上皮性のものが多く，臨床家の遭遇するものは大部分がこれであつて耳下腺原発の非上皮性腫瘍はきわめて稀である。著者らは術前，右耳下腺癌を疑い，全摘出術と右頸部廓清術を行なつたが，急激な白血病様経過を辿つて術後11日目に死亡し，摘出標本の病理組織診断において細網肉腫と判明した症例を経験したので報告する。

　The patient, a 65 year old male affected with reticulum cell sarcoma of the right parotid gland, is reported. Three months ago the patient felt a pain in the infraauricula region which was slightly swollen; the swelling gradually increased in size. Elsewhere, the patient underwent a biopsy of the growth with no specific diagnosis. Thereafter, the growth took a sudden turn of increase in size and developed a facial palsy.

　On admission the tumor was grown to a fist size, hard to touch and fixed to the surrounding tissues. Sialogram indicated malignancy of the right parotid gland.

　Seven days after the admission a total parotidectomy was performed on the patient. The patient complained of headache and fever; finally lost consciousness. The patient finally died 7 days after the operation. The laboratory examinations at this time showed leukocytosis, high level of blood urea nitrogen and LDH and atypical reticulum cells in the peripheral and bone marks.

　Generally the diagnosis of primary reticulum sarcoma of the parotid gland before treatment is extremely difficult to make.