局所切除術を行った脈絡膜悪性黒色腫の1例

A case of choroidal malignant melanoma treated by transscleral resection

　眼底周辺部に存在した小さい脈絡膜悪性黒色腫に対し経強膜局所腫瘍切除術を行い，良好な経過を示した症例を経験した。症例は36歳の男性で，左眼眼底外上方周辺部に半球状に隆起した4乳頭径大の黒褐色の腫瘤がみられ，フルオレセイン螢光眼底造影，ICG螢光造影，超音波検査，MRI検査などの画像診断で脈絡膜悪性黒色腫と診断した。初診時の左眼矯正視力は1.0であった。強膜弁下腫瘍切除術にて腫瘍は全摘出され，切除標本にて類上皮細胞型の脈絡膜悪性黒色腫と診断された。術中，術後に大きな合併症はなく，術後4年後の矯正視力は0.8で，現在まで局所再発，遠隔転移ともにみない。

A 36-year-old male presented with a brown tumor in the superior temporal periphery in his left eye. The tumor was hemispherical in shape and about 4 disc diameters across. The corrected visual acuity was 1.0 in the affected eye. The tumor was diagnosed as choroidal malignant melanoma after fluorescein and indocyanine green angiography, ultrasonography, computed tomography and magnetic resonance imaging. The tumor was surgically removed in toto by lamellar sclerochoroidocyclectomy, vitrectomy, scleral encircling and transscleral cryoapplication. Histological studies showed the tumor to be malignant epithelioid-type melanoma of the choroid. There was no complication during or after surgery. There has been no recurrence or metastasis during follow-up for 54 months.