放射線治療が奏効したびまん性脈絡膜血管腫の1例

Radiotherapy was effective in a case of diffuse choroidal hemangioma

要約　目的：びまん性脈絡膜血管腫に対して放射線治療が奏効した症例の報告である。症例：26歳の男性が右眼の視力低下で受診した。生来顔面の右側に血管腫があり，Sturge-Weber症候群と診断されていたという。所見と経過：矯正視力は右0.5，左1.5であり，右顔面の三叉神経第1枝と第2枝の領域に血管腫があり，右眼の上強膜にも血管腫があった。右眼の眼底には黄斑部から乳頭を囲むように赤色の隆起があり，網膜浮腫と滲出性網膜剝離を伴っていた。脈絡膜血管腫と診断し，1回2Gyの2方向からの放射線外照射を20日間に10回，総量20Gy行った。終了から1か月後の光干渉断層計検査で網膜浮腫と網膜下液は消失し，4か月後には右眼視力が1.0に改善した。以後10か月後の現在まで再発ないし照射による合併症はない。結論：びまん性脈絡膜血管腫に対し，放射線治療が奏効することがある。

Abstract.　Purpose：To report a case of diffuse choroidal hemangioma that regressed after radiation therapy. Case：A 26-year-old male presented with blurring of vision in his right eye. He had had hemangioma in the right side of his face since birth and had been diagnosed with Sturge-Weber syndrome. Findings and Clinical Course：His corrected visual acuity was 0.5 right and 1.5 left. Hemangioma was present in the area served by the first and second branch of right trigeminal nerve. Hemangioma was also present in the sclera in his right eye. The right eye showed reddish elevation from the macula to the area surrounding the disc associated by retinal edema and detachment. The finding was diagnosed with choroidal hemangioma. He was treated by external two-port radiation at the dosis of 2Gy per session totaling 20Gy over 20 days. Optical coherence tomography showed absence of retinal edema or detachment one month after radiation. Visual acuity improved to 1.0 4 months after treatment. There has been no recurrence or complication during 10 months until present. Conclusion：Choroidal hemangioma may regress after external radiation.