眼瞼・結膜悪性腫瘍における眼球非温存症例の検討

Review of cases of malignant eyelid or conjunctival tumors treated by orbital exenteration or without surgery

要約　目的：眼瞼または結膜の悪性腫瘍により，手術不能であるか眼窩内容除去術を必要とした症例の報告。対象と方法：過去9年間に経験した眼瞼または結膜を発生母地とする悪性腫瘍108例108眼を検索した。結果：組織学的診断は，脂腺癌46眼，基底細胞癌34眼，扁平上皮癌15眼，悪性黒色腫10眼，Merkel細胞癌2眼，ムチン産生癌1眼であった。6眼（5.6％）には眼窩内容除去術が行われ，3眼（2.8％）では手術ができなかった。手術不能3眼の内訳は，手術拒否1眼，全身状態不良1眼，重度の認知症1眼であった。結論：眼瞼または結膜の悪性腫瘍の症例の約8％では眼球温存ができなかった。

Abstract.　Purpose：To report cases of malignant tumor of the eyelid or conjunctiva who received orbital exenteration or no surgery. Cases and Method：This retrospective study was made on 108 cases of malignant tumor originating in the eyelid or conjunctiva in the past 9 years. All were unilaterally affected. Result：The present series comprised sebaceous gland carcinoma 46 cases,basal cell carcinoma 34 cases,squamous cell carcinoma 15 cases,malignant melanoma 10 cases,Merkel cell carcinoma 2 cases,and 1 case of mucinous adenocarcinoma. Orbital exenteration was performed in 6 cases（5.6％）. No surgery was performed in 3 cases due to refusal of surgery,poor general status and dementia in one case each. Conclusion：In cases of malignancy of the eyelid or conjunctiva,the eyeball could not be preserved in about 8％ of them.