マイトマイシンC点眼抵抗性の結膜上皮内癌に5-フルオロウラシル点眼が有効であった1例

Instillation of 5-fluorouracil was effective for conjunctival intraepithelial neoplasia refractory to mitomycin-C

目的：マイトマイシンC点眼後に再発した結膜上皮内癌に対し，5-フルオロウラシルが奏効した症例の報告。症例：75歳男性が左眼視力低下で受診した。矯正視力は右1.0，左0.5で，左眼の角膜にゼラチン様の異常上皮が伸展していた。生検で結膜上皮内癌と診断した。経過：0.04％マイトマイシンC点眼を1週間行い腫瘍が縮小した。3か月後に再増殖したがマイトマイシンC点眼で縮小した。6か月後に再発した腫瘍に対し1％ 5-フルオロウラシル点眼を1週間行い，6週後に腫瘍は消失した。その6か月後の現在まで再発または転移はなく，左眼矯正視力0.9を維持している。結論：マイトマイシンC点眼に抵抗する結膜上皮内癌に5-フルオロウラシル点眼が奏効する症例がある。

Purpose：To report a case of conjunctival intraepithelial neoplasia that recurred after topical mitomycin-C and that resolved by instillation of 5-fluorouracil. Case：A 75-year-old male presented with blurring of vision in his left eye. His corrected visual acuity was 1.0 right and 0.5 left. The whole left cornea was covered by a gelatinous mass. Biopsy led to the diagnosis of conjunctival intraepithelial neoplasia. Clinical Outcome：The corneal lesion decreased in area after intillation of mitomycin-C for one week. Recurrence 3months later responded well to topical mitomycin-C. Recurrence another 6months later was treated by instillationn of 1％ 5-fluorouracil for one week. The corneal lesion disappeared 6 weeks later. There has been no recurrence or metastasis during 6months until present with visual acuity of 0.9. Conclusion：Topical 5-fluorouracil may be effective for conjunctival intraepithelial neoplasia that recurred after topical mitomycin-C.