眼窩内腫瘍で初発した原発性肺癌の1例

Orbital tumor was the primary clinical sign in a case of pulmonary carcinoma

　片眼の眼球突出，視力障害で初発した肺癌の眼窩内転移の1例を報告した。症例は，全身症状を示さなかった34歳の男性で，急速に進行する右眼の眼球突出と視力障害を主訴に眼科を初診した。画像診断にて，骨破壊を伴って周辺軟部組織に浸潤する右眼窩内腫瘍を認めた。切除標本での病理組織検索で，高分化型腺癌と診断され，この病理所見に基づく全身精査により肺腫瘍が発見され，本例での眼窩内腫瘍は肺癌の転移と診断された。肺癌の眼窩内転移は，本邦では現在まで稀な疾患とされていたが，肺癌の増加に伴い今後増加することが予測され，転移性眼窩内腫瘍の原発巣として肺癌は重要な位置を持ってくるものと考えられる。

A 34-year-old male presented with rapidly pro-gressive visual disturbance and exophthalmos in his right eye. Radiological examinations showed a right robital mass lesion invading the bone and the surrounding tissue. No primary lesion was detected by systemic examinations. Histopathological study of extirpated tumor showed a well-differentiated adenocarcinoma suggestive of metastatic nature. Further examinations led to the detection of a tumor mass in the S6 region of the left lung. The orbital tumor was diagnosed as metastasis from lung carcinoma.

Metastasis of lung tumor to the orbit has been held to be relatively rare in Japan. The increasing tendency of lung carcinoma in Japan seems to result in more instances of metastasis to extrapul-monary organs including the orbit.