上咽頭Adenoid cystic carcinoma 5症例
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概要
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Five cases of adenoid cystic carcinoma of the epipharynx were treated in Tohoku University Hospital during the period between 1971 and 1978. The age of the patients ranged from 39 to 65 years. The site of the origin was lateral wall of the epitharynx including the Rosenmueller fossa and the orifice bank of the Eustachian tube in all 5 cases.<BR>At the time of diagnosis, cranial nerve signs were detected in 2 out of 5 cases, while cervical metastasis was observed in no case.<BR>The method of treatment was local excision, local exision followed by radiotherapy, radiotherapy with cytostatic drug therapy or radiotherapy only.<BR>Tumor recurrence appeared in 4 cases from 7 months to about four years after the end of the initial treatment.<BR>In one case, recurrence was detected 3 times after each local excision and the patient succumbed to the final recurrence. The one case without recurrence is presently undergoing initial therapy.<BR>The characteristic features of adenoid cystic carcinoma are slow growth, tendency to invade nerves, extensive local infiltration which makes high freguency of recurrence after surgical excision, medium radio-resistency, reluctant tendency of metastasis to regional lymph nodes, tendency to multiple recurrences and distant metastasis at the late stage of the disease.<BR>In 4 cases, hematogenic lung metastasis was noted at the late stage of the disease and the survival duration was from 2 years and 8 months to 5 years. The average was 3 years and 9 months.<BR>This duration is half as short as that of adenoid cystic carcinoma of the other head and neck regions. The prognosis of adenoid cystic carcinoma would, therefore, be worse in the epipharynx than in the other head and neck regions.
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