脊索腫2例

REPORT OF TWO CASES OF CHORDOMA

　I．緒言

　頭頸部領域における脊索腫は，胎生期の脊索遺残組織から発生する比較的稀な腫瘍である。発育は緩徐であるが，完全摘出が困難であるため再発しやすく，比較的予後の悪い腫瘍とされている。今回私たちは2例の脊索腫を経験する機会を得たので，治療法などに若干の検討を加え報告する。

　Two cases of chordoma in the head and neckregion are reported.

　Case 1 : A 69-year-old male had complained of nasal obstruction and foreign body sensation in the throat for two months. After the definite diagnosis of chordoma was established by biopsy, a tumor extending from the mesopharynx to the cervical spine was removed as completely as possible by the lateral cervical approach. Seven months later a local recurrence occurred and the second operation followed by cobalt irradiation was performed. The patient died of cerebral bleeding 4 years and 10 months after the first operation.

　Case 2 : A 52-year-old male had complained of nasal obstruction and hyposmia for seven months. X-ray examination revealed that a tumor extended from the posterior edge of the septum to the superior nasopharynx without bone destruction. The tumor was removed as completely as possible by the transmaxillary approach. Histopathological examination showed chordoma. The patient remained without any recurrence 12 months after the operation.

　Chordoma is a rare malignant tumor which originates from the vestigial embryonic notochord. The rate of growth of this tumor is rather slow but local recurrence is reported to be frequent even after radical removal. We concluded from our experience of two cases that surgical removal is the most suitable treatment and that irradiation is not so effective because of low radiosensitivity.