심한 기계성 위눈꺼풀 처짐을 유발한 눈물샘 눈꺼풀엽의 거대 다형성 샘종 1예
A Giant Pleomorphic Adenoma of Lacrimal Gland Involving the Palpebral Lobe Causing Severe Mechanical Ptosis
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목적: 심한 기계성 위눈꺼풀처짐을 유발하여 심각한 시야 장애를 일으킨 눈물샘 눈꺼풀엽에 생긴 거대한 다형성 샘종의 예를 경험하고 종양을 성공적으로 제거하였기에 이를 국내 최초로 보고하고자 한다. 증례요약: 82세 남자 환자가 약 10여 년 전부터 서서히 커지기 시작하여 심한 위눈꺼풀처짐을 일으킨 좌안 위눈꺼풀의 거대 종괴를 주소로 내원하였다. 수술 전 검사한 안와전산화단층촬영에서 혈관종으로 의심되는 2.3 × 2.0 cm 크기의 커다란 종괴가 관찰되었으며, 쌍꺼풀선 피부절개를 통하여 종괴를 완전 적출하였다. 술 후 종괴의 병리조직검사결과에서는 눈물샘의 다형성 샘종이 확인되었다. 술 후 위눈꺼풀처짐은 완전히 회복되었으며, 6개월까지의 경과 관찰 중 눈물 분비의 이상이나 종양의 재발 소견은 나타나지 않고 있다. 결론: 눈물샘 눈꺼풀엽에 생긴 거대한 다형성 샘종을 쌍꺼풀선 피부절개를 통하여 성공적으로 제거하고 심한 기계성 위눈꺼풀처짐을 교정할 수 있었기에 보고하는 바이다.
Abstract
Purpose: To report a rare case of giant pleomorphic adenoma of the lacrimal gland involving the palpebral lobe causing severe mechanical ptosis and visual field defect, which was removed successfully. Case Summary: An 82-year-old man visited our clinic with a large protruding mass on his left upper lid that had grown for approximately 10 years causing severe ptosis. Preoperative orbital CT showed a 2.3 × 2.0 cm sized large mass which was suspicious of hemangioma. The mass was completely excised through a lid crease incision. The histopathologic examination showed typical findings of pleomorphic adenoma. After the surgery, preoperative mechanical ptosis was completely resolved and during the 6 months of follow-up, there was no abnormality of tear secretion and evidence of tumor recurrence. Conclusions: The authors experienced a rare case of giant pleomorphic adenoma of the lacrimal gland involving the palpebral lobe and resolved mechanical ptosis by complete removal of the tumor through a lid crease incision.
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