球結膜下にみられたgiant cell angiofibromaの1例

A case of subconjunctival giant cell angiofibroma

要約　目的：球結膜下に生じた巨細胞血管線維腫（giant cell angiofibroma）の症例の報告。症例：51歳男性が3年前からの左眼結膜の腫脹と充血で受診した。所見：左眼鼻側の球結膜下に2cm×3cmの大きさの囊胞状で軟らかい腫瘤があった。6か月間に変化がなく，診断的治療として腫瘤を単純切除した。病理組織学的に，紡錘形細胞の増殖と多核の巨細胞からなり，腫瘍細胞による偽血管腔形成があった。免疫組織化学で，これらの腫瘍細胞はCD34（＋），CD99（＋），bcl-2（＋）であり，巨細胞血管線維腫と診断した。18か月後の現在まで再発はない。結論：巨細胞血管線維腫が球結膜下に生じた報告は少なく，ごく稀な症例であると考えられる。良性腫瘍とされているが，再発の報告があり注意を要する。

Abstract.　Purpose：To report a case of giant cell angiofibroma in the subconjunctival space. Case：A 51-year-old male presented with swelling and hyperemia of conjunctiva in the left eye since 3 years before. Findings：The left eye showed a cystic and soft tumor beneath the bulbar conjunctiva nasal to the cornea. Its size was 2 cm by 3 cm. There was no change in the tumor during the ensuing 6 months. The tumor was then resected for diagnosis and treatment. It showed proliferation of spindle cells,polynuclear giant cells and formation of pseudovascular spaces lined by tumor cells. The tumor cells were positive for CD34,CD99 and bcl-2 by immunohistochemistry. These findings led to the diagnosis of giant cell angiofibroma. There has been no recurrence during 18 months until present. Conclusion：The present case appears to be a rare one since few cases have been reported regarding giant cell angiofibroma in the subconjunctival space. While this tumor is regarded as benign,caution is needed because cases of recurrence have been reported.