眼窩内腫瘍を契機に発見された原発性肺癌例

Orbital metastasis of lung cancer

Ⅰ．はじめに

　肺癌が早期より全身のさまざまな部位に転移をきたすことはよく知られているが，眼窩内への転移はきわめて稀である^1,2）。眼窩は腫瘍が生じることの少ない部位の1つで，転移性腫瘍となるとその頻度はさらに低い^3）。今回われわれは，眼窩内転移による症状を初発として診断に至った，原発性肺癌の1例を経験したので文献的考察を加えて報告する。

　We reported a rare case of orbital metastasis of lung cancer. A 70-year-old man presented with a 5-month history of swelling of the left upper eyelid. Sinusitis with an orbital abscess was suspected from the finding of CT scan, and he underwent drainage surgery via endonasal endoscopic/extranasal approaches. However, the orbital lesion turned out to be a solid mass, which was histopathologically diagnosed as adenocarcinoma. Postoperative systemic examinations including MRI, PET/CT, and bronchoscopic examination revealed a lung cancer with multiple distant metastases. The patient received palliative radiotherapy to the orbit, but died of respiratory failure 10 months after onset. We should be aware that malignant tumors such as lung and breast cancers may metastasize to the orbit.