涙嚢部に再発した下鼻道血管線維腫の1例

Late involvement of lacrimal sac area in a case of angiofibroma in inferior nasal meatus

　涙嚢部に再発した下鼻道血管線維腫の1例を経験した。症例は32歳女性で，右内眼角部に腫瘤を認めた。4年前に耳鼻咽喉科で右下鼻道血管線維腫の摘出術を受けた。右内眼角部から涙嚢部にかけて弾性軟，表面整で，2.0×1.2cmの腫瘤を触知した。CT, MRI検査では同部に直径2cmの腫瘍陰影を認めた。腫瘍摘出術を施行し，病理組織学的には，血管線維腫であった。前回の手術で鼻涙管に残存した腫瘍が，4年後に涙嚢部に再発したものと考えられた。

A 32-year-old female underwent extirpation of angiofibroma in the inferior nasal meatus 4years before. She now presented with swelling of right medial canthus area. A tumor was palpable over thelacrimal sac and measured 20×12mm. Presence of tumor was also confirmed by computed tomography andmagnetic resonance imaging. The tumor was removed under surgical microscope. It extended from thelacrimal sac to the nasolacrimal duct. It proved to be angiofibroma histopathologically. The tumor apparent-ly remained in the nasolacrimal duct during the initial surgery and recurred in the lacrimal sac 4 years later.