Charif Chefchaouni M, Hajji Z, Berbich O, Bernoussi A, Benchrifa F, Sefiani S, Marti A A, Saïdi A, Berraho A
Clinique d'Ophtalmologie B, Hôpital des spécialités, CHU Avicenne, Rabat, Morocco.
J Fr Ophtalmol. 2003 Mar;26(3):277-80.
Iris melanoma is a malignant melanocytic tumor, making up 1.2%-6.6% of uveal malignant melanomas. The growth of choroidal melanoma during pregnancy is described and a hormonal influence is suggested. We present a case of iris melanoma occurring during pregnancy. A 32-year-old woman, in the 28(th) week of her fifth pregnancy, was referred to the ophthalmologist with a 2-month history of blurred vision and pain in her left eye. The visual symptoms became progressively worse with decreasing vision. Her visual acuity was 20/70 in her left eye, with a temporal, pigmented, prominent iris mass extending into the trabecular meshwork and the corneal endothelium. Elsewhere other pigmented localizations were found in the iris and in the trabecular meshwork. There was secondary glaucoma with intraocular pressure of 36mmHg and C/D=0.9. The right eye was normal. A general physical examination found no pigmented lesions. Chest radiography and hepatic ultrasonography revealed no metastasis. The diagnosis of iris malignant melanoma was made from the diffuse involvement extending into the trabecular meshwork and the advanced secondary glaucoma; an enucleation was performed and histopathological examination confirmed the diagnosis of iris melanoma with involvement of the trabecular meshwork. The patient had no further problems (follow-up of 11 months). From this case report, we discuss the differential diagnosis of iris melanoma and the hormonal influence on its growth.
虹膜黑色素瘤是一种恶性黑素细胞肿瘤，占葡萄膜恶性黑色素瘤的1.2%-6.6%。已有关于妊娠期间脉络膜黑色素瘤生长情况的描述，并提示存在激素影响。我们报告一例妊娠期间发生的虹膜黑色素瘤病例。一名32岁女性，孕5产，妊娠28周，因左眼视力模糊和疼痛2个月就诊于眼科医生。随着视力下降，视觉症状逐渐加重。其左眼视力为20/70，颞侧有一色素性、突出的虹膜肿物，延伸至小梁网和角膜内皮。在虹膜和小梁网的其他部位还发现有色素沉着。存在继发性青光眼，眼压为36mmHg，杯盘比为0.9。右眼正常。全身体格检查未发现色素沉着病变。胸部X线检查和肝脏超声检查未发现转移。根据肿物弥漫累及小梁网及晚期继发性青光眼，诊断为虹膜恶性黑色素瘤；遂行眼球摘除术，组织病理学检查证实为累及小梁网的虹膜黑色素瘤。患者无其他问题（随访11个月）。通过本病例报告，我们讨论了虹膜黑色素瘤的鉴别诊断及其生长的激素影响。
