術前術後化学療法を施行した後に急性リンパ性白血病を発症した上顎骨肉腫の1例

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  • Osteosarcoma of the maxilla followed by onset of acute lymphoid leukemia after chemotherapy
  • ジュツゼン ジュツゴ カガク リョウホウ オ シコウ シタ アト ニ キュウセイ リンパセイ ハッケツビョウ オ ハッショウ シタ ジョウガク コツニクシュ ノ 1レイ

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<p>We describe a case of osteosarcoma of the maxilla followed by the onset of acute lymphoid leukemia after chemotherapy in a 62-year-old woman. She complained of a pedunculated mass in the left side molar region of the maxilla. Panoramic radiography and computed tomography revealed a radiopaque lesion and a soft tissue shadow in the left side of the maxillary sinus, respectively. Continuity between bone and soft tissue shadow was not sharply delineated. Concluding a diagnosis based on these findings was difficult. We performed biopsy twice, and analyses of the biopsy specimens confirmed high-grade osteosarcoma. Three cycles of doxorubicin (Adriamycin) and ifosfamide (AI therapy) were conducted before surgery to excise the tumor that extended to the maxilla, pterygoid plate, and zygomatic bone. The same chemotherapy regimen was repeated twice after the surgical excision. After 5 months of the postoperative chemotherapy, acute lymphoid leukemia developed. Although she received appropriate chemotherapy for acute lymphoid leukemia, she died of sepsis. In patients receiving treatment for osteosarcoma, the onset of secondary leukemia after chemotherapy or simultaneous primary leukemia should be considered during the follow-up period.</p>

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