結膜血管腫を合併したCrow-Fukase症候群の1例

Conjunctival hemangioma in a case of Crow-Fukase syndrome

　47歳男性が10か月前からの右眼球結膜の腫瘤で受診した。約3年前に四肢に浮腫が生じ，さらに胸水が発見された。いったんは結核が疑われたが，全身に暗赤色の皮疹が出現し，生検でglomeruloid hemangiomaが確認された。全身的に髄液蛋白増加，甲状腺機能低下，肝腫大，血清蛋白異常などがあり，Crow-Fukase症候群と診断された。右球結膜の鼻側に，径1cm，有茎性で弾性軟の腫瘤があり，表面が痂皮で覆われていた。腫瘤切除を行い，病理学的にglomeruloid hemangiomaと診断された。本症候群で，皮膚と同じ血管腫が球結膜に生じた最初の報告例である。

　A 47-year-old male presented with a conjunctival tumor in his right eye since 10months before. He had developed edema in the extremities 3 years before. Presence of pleuritis led to presumed diagnosis of tuberculosis. He then developed generalized skin eruptions that proved to be glomeruloid hemangioma by biopsy. Laboratory studies showed elevated protein in cerebrospinal fluid,thyroid hypofunction,liver swelling and abnormal serum protein. He was diagnosed with Crow-Fukase syndrome based on these findings. A tumor was present in the bulbar conjunctiva in his right eye. It was 10mm across,pedunculated,and elastic soft. The excised tumor was identified as glomeruloid hemangioma. To our best knowledge,this is the first reported case of involvement of bulbar conjunctiva in this syndrome.