안와에 발생한 점액종 1예
A Case of an Orbital Myxoma
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목적: 안와에 발생하는 점액종은 매우 드물게 보고되고 있는 질환으로, 저자들은 안와에 발생한 점액종 1예를 경험하였기에 보고하고자 한다. 증례요약: 37세 여자가 좌안의 안와 변연부에 움직이는 무통성의 종괴가 발현되어 내원하였다. 안와 전산화단층촬영에서 경계가 뚜렷한 고형의 종괴가 관찰되어, 절제 및 생검을 시행하였다. 육안상 17×9×10 mm3 크기의 고형의 갈색 종괴였으며, 조직검사상 전반적으로 방추형 세포들이 관찰되었고, 면역조직화학검사상 SMA, S-100 Protein, CD34 검사상 음성 반응을 보여 점액종으로 진단되었다. 결론: 안와 내 발생하는 점액종은 매우 드물지만, 안와에 통증이 없으며, 경계가 뚜렷한 움직이는 종괴를 감별 진단할 때에는 점액종을 염두에 두어야 할 것으로 사료된다. 또한 본 증례처럼, 안와연을 침범한 소견이 있는 경우 재발 위험이 높기 때문에, 종괴에 대한 완전한 제거가 필요하다.
Abstract
Purpose: Orbital myxoma is an extremely rare tumor. To date, only a few cases have been reported in the literature. The present study reports a case of an orbital myxoma and demonstrates the clinical and histological features. Case summary: A 37-year-old woman presented with a painless movable mass in the orbital margin of the left eye. Computed tomography of the orbit revealed a sharply outlined solid mass, and an excisional biopsy was performed. The excised specimen consisted of a 17x9x10 mm3 brownish mass of scattered spindle cells and small vascular spaces in a fibromyxoid background. Immunohistochemically, the tumor cells were not immunoreactive for SMA, S-100 protein or CD34. Histopathologic examination revealed the tumor to be a myxoma. There was no mass lesion in computed tomography of the orbit, and no recurrence or complications were found one month after removal. Conclusions: When a patient presents with a painless and movable mass in the orbital area, orbital myxoma should be considered as a possible diagnosis. The orbital myxoma with bone invasion should be completely removed to prevent the lesion from recurring.
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