脈絡膜悪性黒色腫と腎細胞癌と胃癌の3重複癌の1例

A case of triple malignancy comprising gastric cancer,renal cell carcinoma and choroidal malignant melanoma

目的：既往に胃癌があり，脈絡膜悪性黒色腫と腎細胞癌が発症した症例の報告。症例：72歳男性が左眼視力低下で受診した。10年前に胃癌の手術を受け粘膜内癌であったという。左眼矯正視力は0.3で，滲出性網膜剝離と硝子体側に突出する脈絡膜腫瘍があった。¹²³IによるSPECTで強い集積があり，脈絡膜悪性黒色腫と診断した。全身検索で右腎の4cm大の腫瘍があった。腎摘出を行い組織学的に腎細胞癌と診断された。さらに左眼を摘出し，脈絡膜悪性黒色腫の診断が確定した。結論：本症例は，胃癌，脈絡膜悪性黒色腫，腎細胞癌が併発したきわめて稀な例である。

Purpose：To report a case of gastric cancer,choroidal malignant melanoma,and renal carcinoma. Case and Findings：A 72-year-old male presented with blurring of vision in his left eye. He had had surgery for gastric carcinoma 10 years before. His corrected visual acuity was 0.3 left. His left eye had exudative retinal detachment and protruding choroidal tumor. Single photon emission CT（SPECT）using ¹²³I showed marked accumulation suggestive of choroidal malignant melanoma. Systemic examination led to detection of a tumor in the right kidney. Its size was 4 cm by 4 cm. Resection of the tumor led to diagnosis of renal cell carcinoma. After enucleation,the left eye was diagnosed with choroidal malignant melanoma. Conclusion：The present case of gastric cancer,choroidal malignant melanoma,and renal carcinoma.