毛様体平滑筋腫の1症例

Leiomyoma of the ciliary body. Report of a case

　極めて稀な毛様体平滑筋腫の1例を報告した．症例は63歳男性で，左眼の視力低下を主訴として来院した．左眼の3時から5時の部位に虹彩根部離断を認め，その部の前房内にピンク色の腫瘤と水晶体後方に褐色の腫瘤を認めた．透光性検査では腫瘤陰影を認め，超音波検査では内部エコーを有する充実性腫瘤像を認めた．前眼部螢光造影検査では，いわゆる"veins of a green leaf"（葉脈状）像を呈し，短時間にまだらな腫瘍のstainingを認めた．CT検査では均一な高吸収域を示し，造影剤で増強された．悪性黒色腫を否定できず眼球摘出を施行した．組織診断は平滑筋腫であった．臨床経過の明らかな今日までの報告例，17症例について検討した結果，毛様体平滑筋腫は若年の女性に多く，悪性黒色腫との鑑別には前眼部螢光検査が有用であると考えられた．

A 63-year-old male presented with a large ciliary tumor in the left eye of apparently two years' duration. Iridodialysis was present from 3 to 5 o' clock position. A spherical pink mass was located anterior to the iridodialysis and a pigmented mass posteriorly. These tumors were not translucent. B -scan ultrasonography showed the tumors to be solid in nature. Fluorescein angiography showed the characteristic pattern of 'veins of a green leaf'followed by rapid dye staining in a mottled fashion. Computed tomography showed a homogenous high density area corresponding to the tumor mass. This lesion was enhanced by contrast material.

The affected eye was enucleated on account of suspected malignancy. The tumor measured 11 x 6 x 4 mm in size and was diagnosed, histologically, as leiomyoma. Fluorescein angiography appeared to be of value in differentiating leiomyoma from malignant melanoma of the ciliary body.

Rinsho Ganka (Jpn J Clin Ophthalmol) 42(8) : 913-917, 1988