網膜芽細胞腫の肩甲骨転移後，予後のよい1例

Fair outcome in a case of retinoblastoma metastatic to the scapula

要約　4歳男児が2か月前からの左肩甲骨の腫瘤で受診した。1歳11か月の頃から右眼が白く光ることがあった。2歳10か月で眼科を受診し，網膜芽細胞腫として右眼が摘出された。腫瘍塊は眼球の大半を占めていたが，視神経浸潤はなかった。病理診断は未分化型の網膜芽細胞腫であった。左眼には異常がなかった。左肩甲骨の腫瘤は，生検で網膜芽細胞腫の転移を診断された。化学療法で腫瘍は4週後に著明に縮小した。これに続いて上腕骨頭を温存する肩甲骨全切除を行い，抗がん薬の全身投与を合計14回行った。以後14年が経過した現在まで，再発ないし転移はない。網膜芽細胞腫の遠隔転移があっても，手術と化学療法で完治した症例である。

Abstract.　A 4-year-old boy presented with a tumor in the left scapula of 2 months'duration. His right eye had been found to manifest cat's eye phenomenon at the age of 1 year 11 months. He had been diagnosed with retinoblastoma at the age of 2 years 10 months followed by enucleation. The tumor occupied more than half the eyeball. There was no infiltration in the optic nerve. The tumor was diagnosed with undifferentiated retinoblastoma. His left eye was intact. Biopsy showed the tumor in the scapula to be metastatic retinoblastoma. After the tumor had decreased in size following 4 weeks of chemotherapy,the left scapula was excised while sparing the head of humerus. He then underwent 14 sessions of chemotherapy. He has been doing well without recurrence or metastasis during 14 years after surgery. This case illustrates that distant metastasis of retinoblastoma can be cured by adequate surgery and chemotherapy.