巨大眼瞼結膜癌に対する放射線治療が奏効した1例

Radiotherapy was effective in a case of giant cancer of palpebral conjunctiva

要約　目的：巨大な眼瞼結膜癌を放射線照射で治療した症例の報告。症例：96歳男性が右眼の疼痛と眼瞼腫瘤で受診した。8か月前に他医で腫瘤切除を受け，扁平上皮癌と診断された。2か月前に再切除が行われたが再発した。所見と経過：右眼の上眼瞼結膜に出血を伴う4cm×5cm×3cmの腫瘤があった。磁気共鳴画像検査（MRI）で腫瘤は眼瞼内に限局していた。高齢で認知症があるために放射線治療を行うこととし，15MeVで開始し，70Gyを7週間にわたって照射した。終了後1か月で腫瘤は消失したが，右耳前部リンパ節の腫大が生じた。これも放射線照射で消失した。眼瞼と耳部の放射線皮膚炎以外には合併症はなかった。以後18か月の現在まで，再発はなく順調に経過している。結論：再発進行した眼瞼結膜の扁平上皮癌に電子線による放射線治療が有効であった。

Abstract.　Purpose：To report a successfully treated case of carcinoma of palpebral conjunctiva by radiation. Case：A 96-year-old male presented with pain and tumor in the right eyelid. The tumor had been resected 8 months before in another institution. It was again resected 2 months before followed by recurrence. Findings：The right eye showed a tumor with hemorrhage in the upper palpebral conjunctiva of the right eye. The tumor was 4cm×5cm×3cm in size. Magnetic resonance imaging（MRI）showed the tumor to be localized in the eyelid. He started receiving electron beam radiation due to his age with dementia. A total of 70Gy was applied with 15MeV as the initial intensity over 7 weeks. The tumor disappeared one month later. Grade 2 radiation dermatitis was the sole complication. Another recurrence of tumor in the right preauricular lesion was similarly treated with success. He has been doing well during 18 months until present. Conclusion：Radiotherapy with electron beam was effective in a case of recurrent and advanced carcinoma in the eyelid.