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< 色覚バリアフリー | メイン | SSP:インフルエンザ脳症ガイドライン【... >
2009.09.30 20:30 |  診療  |  その他（医療関連）  |  ミチバ  | 推薦数 : 2

虹彩転移

・ＮＥＪＭのIMAGES IN CLINICAL MEDICINEに虹彩転移の症例が載っていました。見逃さないようにしないと。

Diagnostic Finding in the Iris

Volume 361  Sep 24,2009 No.13

 http://content.nejm.org/cgi/content/full/361/13/e22

この画像なかなか「微妙」ですね。こういうのを見たら、まず転移を疑わないと．．． 

  

・私が、最初に虹彩転移というのがあるということを知ったのは、確か「肺癌」という雑誌だったと思います。下の症例報告だったかどうかは、定かでありませんが．．． 

【症例】虹彩転移で発見された肺腺癌の1例

光岡茂樹、他。

肺癌(0386-9628)44巻2号 Page140(2004.04）

症例は35歳男性。右眼の眼痛と充血を主訴に当院眼科を受診された。当初ぶどう膜炎との診断であったが後に肺腺癌の虹彩転移と診断された。眼痛の対処に苦慮したが眼への放射線治療と全身の化学療法により良好なペインコントロールが得られた。虹彩転移はまれと考えられ報告する。

・もう一つ、医中誌で調べた論文を貼り付けておきます。結構いろんな癌の眼転移があるものですね。（下の論文のみでなく、医中誌でながめてみると）

【原著論文】眼科領域における転移性腫瘍の予後

太田亜紀子、他。

県立がんセンター新潟病院医誌(0549-4788)46巻1号 Page20-21(2007.03)

【抄録】眼科領域における転移性腫瘍13例の予後について検討した。その結果、1)原発巣は肺癌6例、乳癌2例、子宮体癌2例、肉腫2例、急性リンパ性白血病1例で、転移巣は脈絡膜6例、眼窩内浸潤5例、虹彩2例であった。2)転移巣に対する治療は8例で行われ、うち照射が5例、化学療法が3例であった。3)眼科受診から死亡までの転移後生存期間は平均14.0ヵ月で、ほとんどの症例が半年前後で死亡していたが、乳癌は2例とも3年以上生存しており、肺癌に比べ乳癌は転移後も予後が長いという従来の報告と同様の傾向がみられた。4)脈絡膜転移では照射で腫瘍が縮小しても放射線網膜症を来しており、視力低下した症例もあった。一方、虹彩転移では続発緑内障を併発しており、照射で腫瘍が縮小しても眼圧はあまり下がらなかった。

・もう一つ、虹彩転移の画像をどうぞ↓

肺癌の転移

http://www.atlasophthalmology.com/atlas/photo.jsf?node=2941&locale=ja

乳癌の転移

http://www.atlasophthalmology.com/atlas/photo.jsf?node=4590&locale=ja

 

 

以下日記

本日は当直明けで、午前外来。午後は回診、カンファレンス、労働組合との定例の会議、三役会議。なかなか当直明けで１９時過ぎまで病院にいるのは、つらいです。２０時過ぎ帰宅。夕食は、親子どんぶりでした。久しぶり（？）にビール飲んで、今ヘネシー（本物）飲みながらこのブログ書いてます。２１時になったら、ベッドでファウスト読む予定。

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眼球や眼窩って案外肺癌や乳癌がとびますからね....

＞Paul Carpenterさま、そうですか。私は経験ないのですが。（見逃しているのかも）
written by Paul Carpenter / 2009.10.02 08:55

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