転移性脈絡膜腫瘍に対して放射線療法を行った1例

A case of metastatic choroidal tumor treated by radiation

目的：乳癌に原発した転移性脈絡膜腫瘍に放射線療法を行った症例の報告。症例と経過：56歳女性が左眼の視力低下で受診した。5年前に左乳癌の全摘出術を受け，その後多発性骨転移で再発し抗癌薬で加療中であった。左眼黄斑の耳側に5乳頭径大の脈絡膜腫瘍があり，漿液性網膜剝離を伴っていた。乳癌の脈絡膜転移と診断した。以後の4か月間に腫瘍が拡大し，網膜剝離が水晶体後面に接触して眼圧が上昇した。全量30 Gyの放射線療法で腫瘍は縮小し，網膜剝離が減少した。その6か月後に硬性白斑が眼底に出現した。結論：乳癌に原発した転移性脈絡膜腫瘍に対し放射線照射が奏効したが，放射線網膜症が続発した。

Purpose：To report a case of choroidal tumor metastatic from breast carcinoma. Radiation induced regression of choroidal tumor. Case and Findings：A 56-year-old woman presented with impaired visual acuity in her left eye. She had received radical surgery for left breast carcinoma. She had been under anticancer medication for multiple bone metastasis. She showed a choroidal tumor,5 disc diameters across,temporal to the left macula. Serous retinal detachment was also present. She was diagnosed with metastatic choroidal tumor. The tumor enlarged during the next 4months. Radiation therapy was started due to elevated intraocular pressure. The tumor started to regress after radiation totalling 30 Gy. Retinal detachment regressed also. Hard exudates started to increase 6months later. Conclusion：Radiation was effective for choroidal tumor metastatic from breast carcinoma. Radiation retinopathy was the chief complication.