若年女性の涙腺に生じた多形腺腫の1例

Pleomorphic adenoma of the lacrimal gland in a female teenager

要約　目的：若年女性に発生した涙腺多形腺腫の報告。

症例：17歳，女性。13歳頃より右上眼瞼外側の腫れを自覚していた。徐々に増大し，高知大学医学部附属病院に紹介され受診した。

所見と経過：右上眼瞼外側深部に弾性硬の腫瘤を触れMRIではT1強調で低〜等信号，T2強調にて等〜高信号を呈する，境界明瞭な径10mmの腫瘍を認めた。視力低下や複視などの視機能障害はなかった。前方アプローチによる腫瘍全摘を施行した。病理結果は多形腺腫で，腺管構造の増生と，間質の粘液腫様および軟骨様変化を呈していたが，細胞異形成は認めなかった。術後経過は良好で，術6か月後に紹介元へ逆紹介とした。

結論：小児の眼窩腫瘍では類皮囊腫などが多いが，本症例のように多形腺腫の可能性についても留意が必要であると考えられた。

Abstract　Objective：To report a case of lacrimal pleomorphic adenoma in a young female

Case：A 17-year-old female became aware of swelling on the outside of her upper right eyelid from when she was 13 years old. The size gradually increased, and she was referred to the Kochi Medical School Hospital.

Findings and course：An elastic hard mass was palpated in the deep lateral part of the upper right eyelid, and magnetic resonance imaging（MRI）showed a tumor with a well-defined diameter of 10 mm, showing low to equal signal on T1-weighted and equal to high signal on T2-weighted images. No visual dysfunction such as decreased visual acuity or diplopia was observed. Total tumor resection was performed by anterior approach. The pathological examination revealed that the tumor was pleomorphic adenoma. In detail, proliferation of ductal structure and interstitial myxoma-like and cartilage-like changes were observed；however, no cell atypia was observed. The postoperative course was uneventful, and the patient was referred back to the referral clinic six months after the operation.

Conclusion：Dermoid cysts are common in orbital tumors in children, but it is necessary to pay attention to the possibility of pleomorphic adenoma as in this case.