治療に難渋した眼瞼メルケル細胞癌の4症例

Four cases of Merkel cell carcinoma with variable therapeutic responses

要約　目的：腫瘍の拡大切除が行われ，切除した断端に腫瘍の残存がなかったにもかかわらず，転移が生じた2例を含む，眼瞼のメルケル細胞癌4例の報告。

症例：4例はいずれも片眼性で，上眼瞼に発症した。男性3例，女性1例で，年齢はそれぞれ81，81，85，96歳であった。2例は当科で初診，他の2例は他医を受診し，組織学的にメルケル細胞癌と診断された。全例が腫瘍の拡大切除を受け，2例は切除後に放射線治療を受けた。2例は術後8か月，4年11か月で転移を生じなかったが，他の2例ではそれぞれ術後6か月，8か月に転移を生じた。

結論：高齢者の眼瞼のメルケル細胞癌では，迅速で広範囲の切除が第一選択であり，切除後の予防的な放射線治療が望ましい。

Abstract　Purpose：To report four cases of Merkel cell carcinoma of the eyelid. Two cases showed metastasis, even though all the cases showed no tumor cells along the edge of excised specimen.

Cases and Clinical Course：All the 4 cases were unilaterally affected involving the upper eyelid. The series comprised 3 males and one female. They were aged 81, 81, 85 and 96 years. Two cases were diagnosed by us and the other two cases were diagnosed elsewhere. All the cases were diagnosed with Merkel cell carcinoma after radical resection of the tumor. Two cases received radiation after excision. Two cases showed no metastasis for 8 months and 4 years 11 months after resection. Two cases showed metastasis 6 and 8 months respectively after resection.

Conclusion：The present cases show that prompt and extensive excision is the first choice for Merkel cell carcinoma of the eyelid in senile patients, to be followed by prophylactic radiation therapy.