眼窩悪性腫瘍が疑われた眼窩内異物の1例

A case of intraorbital foreign body simulating malignant orbital tumor

　3歳男児に発生し，画像診断にて悪性腫瘍との鑑別に苦慮した細菌性眼窩膿瘍の1例を経験した。原因となった異物は折れた塗り箸の先端で，異物摘出術および術後の抗生物質投与により治癒した。過去に外傷の既往があったものの，患者が幼児受傷時の詳しい状況が不明であったことや慢性の経過をたどったことが，診断を難しくしたものと考えた。

A 3-year-old male child suffered injury in the left eyebrow while playing with a chopstick. He was referred to us after suffering another injury in the left lower eyelid by a toy sward 3 months later. Magnetic resonance imaging showed a mass in the left orbit reaching from the lacrimal gland. Computerized tomography showed erosion of the lateral orbital wall. The findings suggested a malignant orbital tumor. Surgery through the lower eyelid showed a tumor surrounded by thick fibrous capsule. It contained a tip of chopstick and pus material from which Staphylococcus aureus was isolated. Cure was obtained after removal of the foreign body and systemic antibiotics. This case illustrates that an overlooked foreign body in the orbit may present clinical features simulating malignant orbital tumor.