胆管細胞癌原発の転移性脈絡膜腫瘍の1例

A case of choroidal tumor metastatic from cholangiocarcinoma

　79歳男性が左眼網膜剥離で紹介を受け受診した。3年6か月前に胆管細胞癌に対して肝左葉切除術を受け，4か月前に断端再発に対して放射線照射を受けていた。左眼に3象限にわたる裂孔不明の胞状網膜剥離があった。術中にはじめて耳側に脈絡膜腫瘍が発見された。その5週後に全身状態が悪化して死亡した。病理解剖で，胆管細胞癌からの転移性脈絡膜腫瘍であると判明した。悪性腫瘍の既往がある網膜剥離では，術前に眼内転移の可能性を検討ずる必要がある。

A 79-year-old male was referred to us under the diagnosis of retinal detachment in his left eye. He hadreceived partial hepatectomy for cholangiocarcinoma 42 months before. Radiotherapy had been performed for local recur-rence 4 months before. His left eye showed bullous retinal detachment involving three quadrants of the fundus. No retinal break was identified. During surery, a choroidal tumor was detected in the temporal quadrant. He died 5 weeks late aftersystemic deteriorations. Autopsy showed the choroidal tumor to be metastatic from the cholangiocarcinoma. This caseillustrates that retinal detachment with a past history of malignancy may be caused by metastasis to the eye inculudingchoroid.