Dithmar S, Diaz C E, Grossniklaus H E
Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA.
Retina. 2000;20(1):76-9. doi: 10.1097/00006982-200001000-00014.
To report two cases of regional lymphatic spread of primary uveal melanoma.
The clinical records of two patients who underwent enucleation for uveal melanoma and later developed regional lymph node metastases were reviewed. One of the two eyes was initially treated with proton beam irradiation. Histologic sections of the enucleated eyes and excised lymph nodes were examined.
The melanomas arose in the choroid and ciliary body of the two patients and spread to regional lymph nodes 2 years after enucleation. The choroidal melanoma recurred after irradiation, diffusely infiltrated the uveal tract, and extended into the conjunctiva via an emissary canal. The ciliary body melanoma spread through the trabecular meshwork to the conjunctiva.
Choroidal and ciliary body melanoma may rarely exhibit regional lymph node metastasis. This mode of metastasis may occur after extraocular spread and invasion of conjunctival lymphatics.
报告两例原发性葡萄膜黑色素瘤区域淋巴结转移的病例。
回顾了两名因葡萄膜黑色素瘤接受眼球摘除术并随后发生区域淋巴结转移的患者的临床记录。两只眼睛中的一只最初接受了质子束照射。对摘除眼球和切除淋巴结的组织切片进行了检查。
黑色素瘤发生于两名患者的脉络膜和睫状体，并在眼球摘除术后2年扩散至区域淋巴结。脉络膜黑色素瘤在照射后复发，弥漫性浸润葡萄膜，并通过导血管延伸至结膜。睫状体黑色素瘤通过小梁网扩散至结膜。
脉络膜和睫状体黑色素瘤可能很少出现区域淋巴结转移。这种转移方式可能在眼外扩散和结膜淋巴管侵犯后发生。
