虹彩腫瘍によって発見された肺腺癌の1例

A case of iris tumor leading to the detection of lung cancer

　79歳の男性が左眼眼痛で受診した。左眼虹彩毛様体炎と診断，治療し，眼痛は消失した。受診から4週後に，白色の隆起性病変が左眼虹彩に発見された。全身検査で右肺野部に4×5cmの腫瘤が発見され，肺癌が疑われた。左眼の腫瘍は急速に増大し，高眼圧が持続したので，眼球摘出を行った。虹彩腫瘍は腺癌であり，肺癌からの転移と診断した。抗癌剤の全身投与を行ったが，脳転移が続発し，初診から5か月後に死亡した。保存的療法を行っても転移性虹彩腫瘍が続発緑内障になり，眼球摘出が必要になることを示す症例である。

A 79-year-old male presented with ocular pain in his left eye. He was diagnosed with iridocyclitis. His ocular pain disappeared following conventional treatment. Four weeks later, a white tumor was detected in the iris in the affected eye. Systemic examinations led to the detection of a lung tumor of 4×5 cm in size. The iris tumor rapidly increased in size resulting in secondary glaucoma and lasting ocular pain. Enucleation led to the diagnosis of adenocarcinoma, apparently metastatic from lung cancer. In spite of systemic anticancer treatments, cerebral metastasis developed and the patient died 5 months after his initial visit. This case illustrates that metastatic iris tumor may not respond to preservation therapy and may necessitate enucleation for refractory secondary glaucoma.