Liposomal doxorubicinが奏効したエイズ関連結膜カポジ肉腫の1例

Systemic liposomal doxorubicin was effective for AIDS-related Kaposi sarcoma of the conjunctiva

　40歳男性が右眼の充血で受診した。8か月前にHIV抗体陽性が発見された。1か月前にカリニ肺炎があり，後天性免疫不全症候群（エイズ）と診断された。舌に赤色の隆起性病変があり，生検でカポジ肉腫と診断された。カポジ肉腫はさらに上部消化管に進展した。通常の各種化学療法とビンブラスチンの局所投与が行われたが効果は一過性であった。初診から13か月後に両眼の球結膜にカポジ肉腫が発症した。Liposomal doxorubicinを3週ごとに点滴した。5回の投与後に結膜肉腫は著明に縮小し，12回の投与で舌と上部消化管を含む病変は消失した。投与中に骨髄抑制などの副作用はなかった。最終投与から12か月が経過した現在まで再発はない。Liposomal doxorubicinがカポジ肉腫に有効であった症例である。

A 40-year-old man presented with hyperemia in his right eye. He was found positive for human immunodeficiency virus (HIV) antibody 8 months before. He developed pneumocystis carinii pneumonia 8 months before and was diagnosed with acquired immunodeficiency syndrome (AIDS). He then developed a mass lesion in his tongue which was diagnosed with Kaposi sarcoma by biopsy. Kaposi sarcoma progressed to involve the upper gastrointestinal tract. Treatment with multiple chemotherapy and local injection of vinblastine showed limited and temporary responses. Thirteen months after initial visit, Kaposi sarcoma occurred in bilateral bulbar conjunctiva. Intravenous liposomal doxorubicin was started once every 3 weeks. The conjunctival lesion decreased considerably after 5 injections. Lesions in the tongue and upper gastrointestinal tract disappeared after 12 injec-tions with no adverse effects including myelosuppression. There has been no recurrence during 12 months after the last injection. This case illustrates that liposomal doxorubicin may be effective for AIDS-related Kaposi sarcoma involving the conjunctiva.