眼瞼に転移した乳癌の1症例

A case of breast carcinoma metastatic to the eyelid

　症例は43歳の女性。乳癌の手術直後に複視，左眼の上下眼瞼の腫脹が発症した。画像診断の結果，眼窩腫瘤を認めたが，全身検査で他の臓器に異常はなく，腫瘤の性質を推定するのが困難であった。確定診断の目的で眼瞼の試験切除を施行したところ病理組織学的に乳癌の転移（palpe—bral metastasis of breast scirrhous carcinoma）と診断された。当時，眼窩腫瘤も同様に乳癌の転移と考えられたが，2年後の現在，球後の腫瘤は拡大傾向を認めなかった。したがって，眼窩腫瘤は炎性偽腫瘍や眼窩偽リンパ腫などの良性腫瘍である可能性も考えられた。

A 40-year-old woman presented with diplopia and swelling of left eyelids of 6 months' duration. She had undergone left mastectomy and bilateral oophorectomy for stage 4 scirrhous carcinoma of the breast. She had since been under hormonal therapy. When initially seen by us, she showedsubcutaneous tumor masses in upper and lower eyelids in the left eye. There was limitation of left eye movement in upper and lateral gaze. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a retrobulbar mass with irregular margin extending posteriorly along the medial orbital wall. Needle biopsy showed the palpebral tumor to be epithelial hyperplasia. Another explo-rative biopsy proved it to be metastasis from breast carcinoma. The retrobulbar tumor remained sta-tionary during the following 2 years, suggesting the possibility that the tumor mass was partially inflammatory pseudotumor in nature.