Reddy S C, Madhavan M, Mutum S S
Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
Ophthalmologica. 2000 Sep-Oct;214(5):368-72. doi: 10.1159/000027523.
Breast carcinoma is the most common primary tumor producing intraocular metastasis. Metastases to the iris and ciliary body are relatively rare. The authors report a case of a 61-year-old lady, operated for carcinoma of the left breast 3 years back, who presented with symptoms and signs of acute narrow-angle glaucoma in the right eye. A diffuse whitish plaque-like mass in the upper nasal quadrant of the iris with an episcleral nodule on the limbus in the corresponding area and all the signs of acute narrow-angle glaucoma were present in the right eye. Intraocular pressure was controlled medically. Fine-needle aspiration cytology from the episcleral nodule showed malignant cells. Histopathology of the excised nodule showed metastatic poorly differentiated carcinoma, and the cellular pattern was similar to the carcinoma of the breast. There was no other metastasis anywhere in the body. Fine-needle aspiration cytology from an external lesion of the eye is a less invasive and easier procedure than paracentesis to diagnose the metastatic nature of the lesions. The rare features in our case are the clinical presentation as acute glaucoma and the ocular structures being the first and only site of metastasis.
乳腺癌是最常见的发生眼内转移的原发性肿瘤。转移至虹膜和睫状体相对少见。作者报告了一例61岁女性病例，该患者3年前因左乳腺癌接受手术，现右眼出现急性闭角型青光眼的症状和体征。右眼虹膜鼻上象限有一个弥漫性白色斑块样肿物，相应区域角膜缘有一个巩膜结节，且存在急性闭角型青光眼的所有体征。眼压通过药物控制。对巩膜结节进行细针穿刺细胞学检查显示有恶性细胞。切除结节的组织病理学检查显示为转移性低分化癌，细胞形态与乳腺癌相似。身体其他部位未发现其他转移灶。与前房穿刺相比，经眼外部病变进行细针穿刺细胞学检查诊断病变的转移性质是一种侵入性较小且更简便的方法。我们病例中的罕见特征是临床表现为急性青光眼，且眼部结构是首个也是唯一的转移部位。
