胸腺腫に伴うCAR症候群の1例

A patient of thymoma with cancer-associated retinopathy

　64歳女性が2か月前からのぶどう膜炎の悪化で紹介受診した。矯正視力は右0.7，左手動弁であった。強い硝子体混濁のほか，羞明と霧視に伴う進行性の視力低下，輪状暗点，網膜血管の狭細化，眼底色調の粗そう化，蛍光眼底造影での蛍光色素漏出，網膜電図でのa・b波の振幅低下（平坦化）が両眼にあった。胸部画像検査で右肺門部と上前縦隔に腫瘤が発見され，手術により，浸潤性胸腺腫と診断した。血清から抗リカバリン抗体が検出され，腫瘍関連網膜症（cancer-associated retinopathy：CAR）と診断した。受診から1年後の現在，患者の経過は良好である。

　A 64-year-old woman presented with progressive uveitis since 2 months before. Her corrected visual acuity was 0.7 right and hand motion left. She had vitreous opacity,photophobia,ring scotoma,narrowing of retinal vessels,mottled fundus,and reduced amplitudes of a and b waves on electroretinogram. Diagnostic imaging showed a tumor in the upper anterior mediastinum. It proved to be thymoma after surgery. Anti-recoverin antibody was present in the plasma. She was diagnosed with cancer-associated retinopathy. She is doing well during one year after her initial visit.