硝子体播種を伴った脈絡膜悪性黒色腫

Choroidal malignant melanoma with vitreous seeding

　左眼飛蚊症で来院し，左眼底上耳側に黒色で出血を伴う約10乳頭径の腫瘍が網膜を穿孔し，硝子体中に突出している55歳の男性例を報告する。後極部を中心として網膜面上に色素の集積物が散在し，硝子体中には色素を認めた。CT，MRI，超音波検査で約15×10×10 mmの腫瘍が確認された。螢光眼底撮影で，腫瘍周囲からコロナ状の螢光漏出を認めた。以上より硝子体播種を伴った脈絡膜悪性黒色腫と診断した。眼外への転移はなく，左眼球摘出術を施行した。病理組織は脈絡膜悪性黒色腫のspindle B typeであった。術後転移再発予防のため補助的化学療法を施行した。

A 55-year-old male presented with primary chor-oidal malignant melanoma with vitreous seeding. He showed cloudy vitreous and diffuse pigment deposits on the retinal surface in his left eye. A pigmented tumor was located in the superior tem-poral quadrant in the left eye. The tumor was about 10 disc diameters across. The right eye was normal. Systemic examinations were inconspicuous. Com-puted tomography, magnetic resonance imaging and ultrasonography showed the tumor to be local-ized within the left eye and the size to be 15×10× 10 mm. The left eye was enucleated followed by chemotherapy with DTIC, ACNU and VCR. His-tological studies showed the tumor to be spindle B malignant melanoma originating in the choroid which broke through the Bruch's membrane and the retina to spread into the vitreous with vitreous seeding.