毛様体悪性黒色腫，胃癌および食道癌の3重複癌の1例

A case of triple malignancies including gastric cancer,malignant melanoma of ciliary body and esophageal cancer

要約　目的：胃癌の既往がある患者に毛様体悪性黒色腫が生じ，眼球摘出後に食道癌が発症した報告。症例：65歳男性が左眼の視野欠損で受診した。3年前に胃癌のため胃全摘出術を受け，中分化型管状腺癌であったという。左眼の硝子体腔内に黒色の腫瘤があり，毛様体悪性黒色腫として左眼を摘出した。類上皮型の悪性黒色腫であった。その5年後に悪性黒色腫の肝転移が発見され，上部消化管内視鏡で食道癌があり，生検で低分化型扁平上皮癌と診断された。初診から8年後に多発性骨転移で死去した。結論：本症例での胃癌，毛様体悪性黒色腫，食道癌はいずれも原発性で，稀有な3重複癌であったと解釈される。

Abstract.　Purpose：To report a case of triple malignancies including gastric cancer,malignant melanoma of ciliary body and esophageal cancer. Case：A 65-year-old male presented with visual field defect in the left eye. He had received total gastrectomy for gastric cancer 3 years before. The cancer was allegedly adenocarcinoma. Findings：The left eye showed a black mass in the vitreous. Clinical features were suggestive of malignant ciliary body melanoma. Enucleation led to the diagnosis of epithelioid type of malignant melanoma. He was diagnosed with hepatic tumor metastatic from ciliary body melanoma 5 years later. Esophageal cancer was also detected by endoscopy. Biopsy showed the tumor to be poorly differentiated squamous cell carcinoma. He died of multiple bone metastases at the age of 73 years. Conclusion：Gastric cancer,malignant melanoma of ciliary body and esophageal cancer in this case were primary in origin. This patient is regarded as a very unusual instance of triple malignancies.