眼瞼Merkel細胞癌の2例

Two cases of Merkel cell carcinoma of the eyelid

要約　目的：眼瞼に発症したMerkel細胞癌2例の報告。症例と経過：症例は75歳と83歳の女性。1例は左上眼瞼，他の1例は左下眼瞼に急速に増大する腫瘤が生じた。いずれも原発巣を切除し，局所皮膚弁で再建した。1例は高齢なので頸部郭清術を行わず，術後に放射線療法を施行した。他の1例は高齢と認知症のため頸部郭清術と放射線療法を施行しなかった。2例とも局所再発はなく，頸部リンパ節転移によりそれぞれ術10か月と6か月後に死亡した。結論：眼瞼のMerkel細胞癌では，拡大切除，頸部郭清術と術後の放射線療法が望ましい。高齢や合併症でこれらが不可能であっても，原発巣の切除と再建は患者の生活の質（QOL）の向上に有用である。

Abstract.　Purpose：To report two cases of Merkel cell carcinoma of the eyelid. Cases and Findings：Both were females aged 75 and 83 years respectively. They had rapidly enlarging tumor in the left upper and left lower eyelid respectively. Both cases received resection of tumor and reconstruction of the eyelid with local skin flaps. The tumor was diagnosed with Merkel cell carcinoma. No dissection of cervical lymph nodes was performed in both cases due to advanced age. Radiation therapy was performed in one case and not in the other because of dementia. Although there was no recurrence in the eyelid,metastasis to the cervical lymph nodes led to death 10 and 6 months respectively after surgery. Conclusion：Merkel cell carcinoma of the eyelid is best treated by wide excision followed by lymph node dissection and radiation. In cases who cannot be thus treated,resection of primary tumor and reconstruction will contribute to improve the quality of life.