眼部にAIDS関連カポジ肉腫を認めた1例

A case of AIDS-related Kaposi sarcoma in the eyelid

要約　目的：眼部に後天性免疫不全症候群（AIDS）関連カポジ肉腫を認めた1例を報告する。

症例：35歳，男性。6か月前に右下眼瞼の腫瘤を近医で切開をされたが軽快しなかった。その後，健康診断で肺野の異常陰影を指摘されAIDSと診断，九州大学総合診療科から九州大学眼科を紹介された。右下眼瞼外側に暗赤色の有痛性腫瘤，左眼球結膜に赤色腫瘤性病変を認めた。右下眼瞼の生検でカポジ肉腫と診断した。肺と消化管にも腫瘍が多発していた。Highly active anti-retroviral therapyに加えてリポソーマルドキソルビシン投与を6クール行い，腫瘍は消失した。

結論：AIDS関連カポジ肉腫の患者がAIDSの自覚なく眼科を初診しうるので注意が必要である。

Abstract　Purpose：To report a case of AIDS-related Kaposi sarcoma in the eyelid.

Case：A 35-year-old man had noted a tumor in the lower eyelid since 6 months before. It gradually increased in size following transconjunctival incision and curettage. Multiple foci in the lung were detected during health check-up 4 months before. He was diagnosed with AIDS at the Department of Internal Medicine of Kyushu University. He was referred to us regarding the eyelid tumor.

Findings and Clinical Course：A painful, dark red mass was present in the right lower eyelid. Another red mass was present in the left bulbar conjunctiva. The tumor in eye right eyelid was resected and proved to be Kaposi sarcoma. Metastatic lesions were present in the lung and gastrointestinal tract. He was treated with highly active antiretroviral therapy（ART）and six courses of liposomal doxorubicin. Tumors in the eyes, lung, and gastrointestinal tract disappeared 6 months after end of treatment.

Conclusion：This case illustrates that a tumor in the eyelid may be initial clinical manifestation of AIDS-related Kaposi sarcoma.