眼症状をもって初発した肺癌の眼窩内転移の1症例

Orbital metastasis led to the detection of lung carcinoma. Report of a case

1）左眼痛，左眼外転神経麻痺で初発し，急速に全眼筋麻痺，失明に至った肺癌の眼窩内転移の症例を報告した．

2）全身的にも複数の転移巣が認められ，眼症状発現から1カ月で死亡した．

3）剖検では眼窩後方に30mm×10mmの腫瘍を認め，組織学的に肺原発の低分化腺癌の転移と考えられた．

4）肺癌の眼窩内転移は，本邦では本症例を含めて現在までに3例の報告しかなく，稀な疾患ではあるが，肺癌の罹病率の増加と共に，今後増加することが予測される．

A 60-year-old male presented with painful ophth-almoplegia and decreased visual acuity in the left eye. Abducens nerve palsy and retrobulbar optic neuropathy in the left eye were elicited by further examination. Total ophthalmoplegia developed 2 weeks later. Systemic evaluation was suggestive of lung carcinoma with multiple metastasis. Death followed from respiratory problem one month after occurrence of eye symptoms.

On autopsy, tumor cells were located around the posterior intraorbital portion of the left optic nerve. The tumor proved to be metastatic adenocarcinoma from the lung.

Metastasis of lung carcinoma to the orbit has been held to be relatively infrequent in Japan. Only 2 cases have been reported in earlier literature. Orbital metastasis will become more common along the current increasing tendency of lung car-cinoma in Japan.

Rinsho Ganka (Jpn J Clin Ophthalmol) 42(11) : 1283-1286, 1988