小唾液腺由来と考えられた眼窩先端部腺癌の1例

A case of orbital apex adenocarcinoma of suspected minor salivary gland origin

眼窩先端症候群は，眼窩先端部の病変により上・下眼窩裂や視神経管を通過する脳神経の障害を呈する症候群である^1）2）。今回我々は，眼窩先端部に発生し，アスペルギルス症と鑑別を要した，小唾液腺由来と考えられた腺癌の1例を経験したので，文献的考察を加えて報告する。

An 80-year-old woman presented with progressive left visual loss. CT showed an ill-defined, irregular osteolytic mass centered at the orbital apex with extension into the posterior ethmoid sinus. MRI demonstrated marked T2 hypointensity within the orbital apex lesion. Histological findings favored adenocarcinoma, suspected to arise from a minor salivary gland. This case highlights that minor salivary gland carcinoma should be included in the differential diagnosis for destructive, infiltrative orbital apex lesions and carefully distinguished from orbital apex aspergillosis, because management and prognosis differ and timely, appropriate therapy is critical.