下垂体腺腫を伴った脈絡膜骨腫の1例

Choroidal osteoma in a case of pituitary adenoma

　30歳女性が糖尿病と成長ホルモン高値を伴う下垂体腺腫と診断され，眼科的検査のため受診した。矯正視力は右1.0，左1.2であった。右眼眼底の乳頭上方に2.3×3.3乳頭径大の境界が比較的鮮明な機黄色の病変があり，脈絡膜骨腫と診断した。眼科受診の1か月後に下垂体腺腫亜全摘手術が行われた。6年後に骨腫は3.4×3.8乳頭径大に拡大したが，血管新生などの合併症はなく，良好な視力を維持している。成長ホルモン産生型下垂体腺腫に脈絡膜骨腫が合併した報告例はないが，前者が後者の発症の一因となった可能性がある。

A 30-year-old woman was referred to us after diagnosis of pituitary adenoma associated with diabetes mellitus and elevated level of growth hormone. Her corrected visual acuity was 1.0 right and 1.2 left. Funduscopy showed a yellow-orange lesion with relatively well-defined margin superior to the disc in her right eye. Its size was 2.3×3.3 disc diameters. We diagnosed the lesion as choroidal osteoma. She underwent subtotal removal of pituitary adenoma one month later. After the follow up for 6 years, the osteoma enlarged to 3.4×3.8 disc diameters. There has been no choroidal neovascularization nor deterioration in visual acuity. There is no reported case of pituitary adenoma associated with choroidal osteoma to the best of our knowledge. There is a possibility that growth hormone-producing pituitary adenoma may have been involved in the pathogenesis of choroidal osteoma.