Romanowska-Dixon Bozena
Katedry i Kliniki Okulistyki Collegium Medicum Uniwersytetu Jagiellońskiego w Krakowie.
Klin Oczna. 2002;104(5-6):395-7.
To estimate the influence of pregnancy on the development and treatment of choroidal melanoma.
8 pregnant women in the age of 20 to 35 years were observed. Various methods of treatment were applied: enucleation of the eye, photocoagulation and brachytherapy. 6 women delivered healthy babies, in 1 case an abortion happened and the child died, in 1 case therapeutic abortion was performed. The time of observation was 4 to 11 years, (average 6.8 year).
The majority of patients visited the ophthalmologist for the first time during pregnancy or just after delivery, because they noticed impairment of vision in the eye with tumor. One can suppose, that during pregnancy the tumors growth is fast. Regression of the tumor after treatment was observed in 4 cases. In 4 women the eye was enucleated. 7 women are still alive. Only in one case metastases to the liver and the lungs occurred and the patient died. Considering the lack of estrogen and progesterone receptors in melanoma, this can be explained by the decreased immunity of the pregnant women organisms. Our observations do not reveal any negative influence upon pregnancy as the results of the treatment. Photocoagulation of the tumor can be performed safely during the first months of pregnancy. It seems, that brachytherapy is safer towards the end of pregnancy or after delivery.
评估妊娠对脉络膜黑色素瘤发生发展及治疗的影响。
观察8例年龄在20至35岁的孕妇。采用了多种治疗方法：眼球摘除术、光凝治疗和近距离放射治疗。6名妇女分娩出健康婴儿，1例发生流产且胎儿死亡，1例行治疗性流产。观察时间为4至11年（平均6.8年）。
大多数患者在孕期或产后首次就诊于眼科医生，因为她们注意到患肿瘤眼睛的视力受损。可以推测，孕期肿瘤生长迅速。4例患者治疗后肿瘤出现消退。4名女性接受了眼球摘除术。7名女性仍然存活。仅1例发生肝肺转移，患者死亡。考虑到黑色素瘤中缺乏雌激素和孕激素受体，这可能是由于孕妇机体免疫力下降所致。我们的观察未发现治疗结果对妊娠有任何负面影响。肿瘤光凝治疗可在妊娠的头几个月安全进行。似乎近距离放射治疗在妊娠晚期或产后更安全。
