眼症状を契機に明らかとなった胸腺原発の転移性脈絡膜腫瘍の1例

A case of thymic carcinoma with choroidal metastasis as the initial manifestation

要約　目的：転移性脈絡膜腫瘍を契機として発見された胸腺癌の症例の報告。症例：62歳男性が4日前に突発した左眼の変視症で受診した。矯正視力は右1.0，左1.2であり，左眼黄斑の上耳側に2乳頭径大の漿液性網膜剝離があった。蛍光眼底造影ではこの部位に顆粒状過蛍光があった。17日後にこの部位に黄白色の隆起性病変が生じた。32日後には6乳頭径の大きさになり，視力は0.06になった。全身検索で胸腺癌が発見され，眼病変はこれからの転移性脈絡膜腫瘍と診断された。結論：全身的に悪性腫瘍の既往がなくても，転移性脈絡膜腫瘍が起こることがある。

Abstract.　Purpose：To report a case choroidal tumor that proved to be metastatic from carcinoma of the thymus. Case：A 62-year-old male presented with metamorphopsia in his left eye since 4 days before. His corrected isual acuity was 1.0 right and 1.2 left. The left eye showed serous detachment of 2 disc diameters（DD）in size was present superior-temporal to the macula. Fluorescein angiography showed diffuse granular hyperfluorescence in the area of retinal detachment. A yellowish-white elevated lesion appeared in this area 17 days later. It enlarged to 6DD in size 32 days laterwith visual acuity reduced to 0.06. Systemic examinations led to the detection of thymic carcinoma. The fundus lesion was diagnosed with metastatic choroidal tumor. Conclusion：This case illustrates that metastatic choroidal tumor may develop in the absence of history of systemic malignancy.