소아에서 발생한 눈물샘 여러형태샘종 1예
Pleomorphic Adenoma of the Lacrimal Gland in a Child
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목적: 소아에서 발생한 눈물샘 여러형태샘종의 증례를 경험하였기에 문헌 고찰과 함께 보고하고자 한다. 증례요약: 7세 남아가 2개월 전 발생한 좌안 안구돌출 및 좌안 상안검 안검하수를 주소로 내원하였다. 안구돌출 및 안검하수 외에 다른안과적 특이소견은 없었다. 안와 자기공명영상에서 눈물샘 내부에 경계가 분명한 종양이 관찰되었고, 종양에 의해 안와 상벽(orbitalroof)에 압박진무름(pressure erosion) 소견이 동반되었다. 이에 가쪽 안와절개술을 시행하여 눈물샘 종양을 절제하였고 병리 조직검사상 상피성과 중간엽성 분화를 모두 보이며, 다양한 크기의 관상 구조(duct)가 관찰되었고, 편평 화생(squamous metaplasia) 및케라틴 형성 등의 소견을 보여 눈물샘 여러형태샘종으로 진단하였다. 결론: 소아에서 발생한 눈물샘 종괴의 감별진단으로 눈물샘 여러형태샘종을 고려해야 한다.
Abstract
Purpose: To report one case of pleomorphic adenoma of the lacrimal gland in a child. Case summary: A 7-year-old boy presented with a 2-month history of an exophthalmos and mild ptosis of the left eye; therewere no other ophthalmologic problems. Orbit MRI revealed a well-defined mass in the left lacrimal gland and a defect inthe orbital roof due to pressure erosion. Tumor resection was performed via a lateral orbitotomy and a biopsy wasrequested. The biopsy revealed tumor tissue that was composed of epithelial elements with variably sized duct formation. Focal squamous metaplasia and keratin production was also observed. Conclusions: Pleomorphic adenoma of the lacrimal gland should be considered as a differential diagnosis of a lacrimalgland mass in a child.
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