側頭窩に発生した海綿状血管腫症例

CAVERNOUS HEMANGIOMA OF THE TEMPORAL FOSSA: A CASE REPORT

　I．はじめに

　血管腫は皮膚，皮下組織，粘膜や肝などの内臓諸臓器に好発し，一般的には真の腫瘍でなく先天的な組織奇型（過誤腫hamartoma）と考えられている。そしてこの腫瘍は大部分が小児期までに発見されるという。

　今回われわれは特別な体位で出現する左顔面腫瘤を訴えて来院し，試験開放の結果側頭窩に発生した海綿状血管腫と病理診断された症例を経験した。症状発現年齢は44歳であり臨床症状，腫瘍発生部位とも血管腫としては文献的にも非常にめずらしい症例である。確定診断に至つた経過を述べるとともに多少の文献的考察も加えて報告する。

　A man, aged 44, noticed a left facial mass of seven months' duration only when he was in the supine position. No traumatic episode was experienced.

　On examination a mobile, painless, soft and fluctuant mass was found in the left lateral portion of the left eye in the head down position, approximately 3×3 cm in size. There was no evidence of a bruit or thrill.

　Tomogram of the facial bone and CT scan were informative but not conclusive. Aspiration of the mass produced 5 cc of dark red blood, and the direct injection of contrast medium showed a broad mass lesion (mainly in the temporal fossa).

　Exproratory biopsy was performed, and the histological examination revealed cavernous hemangioma.

　Hemangiomas are congenital in origin and comprise the largest group of childhood tumors. Although any organ may be affected, the skin is by far the most common site.

　Regarding to the patient's age, the location of the tumor, symptoms and signs, this case was very much interesting.