年長児に発生した網膜芽細胞腫の3例

Retinoblastoma in children of advanced age

要約　目的：8歳の女児3例に発症し，非典型的な所見を呈した網膜芽細胞腫の報告。症例：3例とも片眼性で，主訴は1例が患眼の充血，2例が視力低下であった。患眼の視力は1例が1.5でぶどう膜炎様の眼内炎があり，2例が手動弁で硝子体混濁または出血があった。全例を通じ，画像診断で眼内の腫瘤または石灰化はなかった。いずれも眼球摘出を行い，硝子体播種がある網膜芽細胞腫の診断が確定した。それぞれ7年，4年，16か月の経過観察で再発または転移はない。結論：これら年長児に発症した網膜芽細胞腫は，いずれも非特異的な臨床所見を呈し，注意が必要である。

Abstract.　Purpose：To report 3 children who developed retinoblastoma with atypical clinical manifestations at the age of 8 years each. Cases：All the 3 cases were girls and were unilaterally affected. One case had hyperemia of affected eye as chief complaint. Her left eye simulated uveitis with visual acuity of 1.5. The other 2 cases showed vitreous opacity or hemorrhage with visual acuity of hand motion. Diagnostic imaging showed no intraocular tumor or calcification in all the cases. Enucleation led to the diagnosis of retinoblastoma with vitreous dissemination in the 3 cases. There has been no recurrence or metastasis during the follow-up for 16 months,4 years and 7 years respectively. Conclusion：The present cases illustrate that retinoblastoma in children of advanced age may show atypical clinical manifestations. This particular feature needs due attention.