角結膜腫瘍切除術・冷凍凝固・マイトマイシンC併用療法が有効であった角結膜上皮内癌の1例

A case of corneal and conjunctival intraepithelial neoplasia treated by resection, cryopexy and mitomycin C

要約　目的：角結膜腫瘍切除術・冷凍凝固・マイトマイシンC併用療法が有効であった角結膜上皮内癌の報告。

症例：75歳，男性。左眼異物感自覚。初診時，耳側角膜表層混濁と球結膜の結節状隆起病変および流入血管を認めた。生検時の病理組織検査の結果，低悪性度の上皮内癌と診断。2週後球結膜腫瘍拡大切除術＋角膜上皮掻爬術＋輪部冷凍凝固術＋0.04％マイトマイシンC（MMC）塗布を施行。病理組織検査結果は陰性であった。術翌日から0.04％MMC点眼（1日4回，3週間点眼）を1クール施行。1年6か月後も再発はなく経過良好である。

結論：結膜上皮内癌の治療には角結膜腫瘍切除術・冷凍凝固・MMCの3者併用療法が有効と思われた。

Abstract　Purpose：To report a case of corneal and conjunctival intraepithelial neoplasia treated by resection, cryopexy and mitomycin C.

Case：A 75-year-old male presented with foreign body sensation in the left eye. The left eye showed infiltration of semitransparent gelatinous vascular membrane into the temporal sector of the cornea and conjunctiva. The lesion was treated by resection. Histopathological studies showed low-grade carcinoma in situ. The eye received, 2 weeks later, extended resection, cryopexy and topical 0.04％ mitomycin C. He received topical instillation of mitomycin C 4 times daily for 3 weeks. There has been no recurrence of neoplasia or dysplasia for 18 months until present.

Conclusion：Resection, cryopexy and topical mitomycin C was effective in the present case of corneal and conjunctival intraepithelial neoplasia.