眼瞼悪性腫瘍のレーザー局所温熱療法による治療の試み

Laser hyperthermia therapy for a malignant tumor of the eyelid

　腫瘍周囲の健常組織を含む広範な切除が必要であり，眼瞼再建術の問題も伴う眼瞼の悪性腫瘍に対し，局所温熱療法を試みた．症例は82歳の女性で，約1年来上眼瞼に腫瘤を触れ，組織検査の結果マイボーム氏腺癌と診断されていた．局所温熱療法には人工サファイア製プローブを用い，連続発振型Nd：YAGレーザー光の低出力（2ワット）断続照射にて，局所を42〜45℃に15分間加温した．

　第1回照射2週間後頃より腫瘍は著明に縮小したが，2週間隔で前後3クールの温熱療法を行った．第1回照射後7カ月現在，周囲組織と癒着しない小腫瘤を眼瞼皮膚上から触れるが，耳前腺等の腫脹など癌腫の転移を思わせる所見は認めていない．また治療後に眼瞼運動障害などの副作用は全く見られず，角膜にも変化は見られなかった．

We treated sebacenous carcinoma in the right upper eyelid of a 82-year-old female by local ther-motherapy.

We used a contact laser probe made of a single artificial Al₂O₃ crystal to apply heat to the tumor from a continuous-wave Nd-YAG laser system. After conventional surface anesthesia, the tumor was heated directly via the palpebral conjunctiva. The temperature in the tumor was controlledbetween 42° and 45℃ by applying intermittent irra-diation at an output level of 2 watts.

The tumor mass started to regress 2 weeks after the session. Recurrence occurred 3 months later but could be effectively treated by additional treat-ments. No metastasis has been seen during the follow up of 7 months. The treatment was noted forabsence of complications as dysfunction of the eyelid or corneal erosion.

Rinsho Ganka (Jpn J Clin Ophthalmol) 41(8) : 969-972, 1987