Mustard Gas喉頭癌の1例

抄録

1) A 46-year-old man who had worked during 1941-1945 in a former Japanese army poison gas (chemical weapon) manufacturing factory mainly produced mustard gas, complained of sore throat, swelling of the neck and otalgia since 1962, and was diagnosed as having supraglottic cancer (T₄N₃M₀).
Biopsy showed squamous cell carcinoma. The latent period of carcinoma induction was about 21 years.2) The tumor of this case already extended from the left ventricular fold through the left side of epiglottis and aryepiglottic fold to the extrinsic laryngeal muscles. Metastasis was found in the left deep cervical lymph nodes without metastastic markings of the lung. He was treated in 1962 with total larygectomy with left radical neck dissection followed by 6000R. Co⁶⁰ irradiation.
No cervical or distant metastasis has been recognized in 1967.
3) This factory was located on the Island of OKU-NO-JIMA, a small island in the Inland sea, Japan. Among these workers, frequent occurrences of laryngeal and bronchogenic cancer were reported by A. YAMADA.
4) The carcinogenecity of mustard gas including itsderivatives has been clinically and experimentally confirmed. Accordinng to YAMADA's investigation, 32 consecutive cases were reported-18 cases of bronchogenic cancer, 7 cases of laryngeal cancer, 3 cases of pharyngeal cancer, 3 cases of cancer of the spheniod sinus and one case of cancer of the tongue.
5) Eight cases of cancer of the larynx were reported. All cases were male of the average age of 54 year-old, which was younger than that of usual laryngeal cancer. They suffered from excessive cough and expectoration since their engagement in prodution of the mustard gas.
The average latent period for carcinoma induction was 19 years and our case was 21 years. The histological type was squamous cell carcinoma.
Concerning the sites of the cancer, the site of predilection was the supraglottic region, while only one case was in the subglottic region. In eight cases the glottic cancer was not encountered.
6) The incidence of the occupational cancer of the larynx has been very rarely reported. But we believe that these laryngeal cancers observed in the workers having engaged in the production of the mustard gas. are one of the occupational cancer.