涙嚢部原発腺様嚢胞癌の1例

A case of adenoid cystic carcinoma originating in the lacrimal sac

　49歳女性が10か月前に右眼内眼角の鼻側に腫瘍を自覚した。鼻涙管通過障害はなかった。径20mmで弾性硬の腫瘍が当科初診時にあった。磁気共鳴画像法を含む臨床所見から，涙嚢の慢性炎症または悪性腫瘍が疑われた。腫瘍摘出術後の病理診で涙嚢原発の腺様嚢胞癌と診断された。周囲への転移はなかった。涙嚢癌の頻度は極めて低いが，臨床像が慢性涙嚢炎に酷似することがあるので，十分な注意が必要である。

A 49-year-old female noted a tumor nasal to the right medial canthus 10 months before. The nasolacrimal duct was reportedly patent. An elastic tumor of about 20 mm in diameter was present in the lacrimal sac area. Clinical findings including those by magnetic resonance imaging (MRI) were suggestive of inflammatory tumor or malignancy of the lacrimal sac. Dacryocystectomy including the tumor showed adenoid cystic carcinoma involving and presumably originating from the lacrimal sac. No metastasis was present. Carcinoma of the lacrimal sac is a rare occurrence but would demand due attention because of its similarity to chronic dacryocystitis in its clinical manifestations.