Küchle M, Holbach L, Schlötzer-Schrehardt U
Department of Ophthalmology, University of Erlangen-Nürmberg, Germany.
Eur J Ophthalmol. 1992 Jan-Mar;2(1):3-9. doi: 10.1177/112067219200200102.
A 50-year-old white man complained of "inflammation" of his right eyelid since January 1989. In June 1990, he had undergone a gastrectomy for an adenocarcinoma of the stomach. In August 1990, his right eye showed a painless, firm infiltration of the upper and lower lid, ulceration and loss of eyelashes of the upper lid and a reddish, subepithelial thickening of the medial bulbar conjunctiva. Biopsies of the right upper lid and nasal bulbar conjunctiva disclosed a metastatic, poorly differentiated adenocarcinoma of the stomach (signet ring cell carcinoma) both in the lid and conjunctival biopsies. Carcinoembryonic antigen (CEA) was detected in the tumor cells. Electron microscopic examination revealed tumor cells with signs of secretory activity. Although metastases to the eyelids and conjunctiva are rare, they may precede the clinical manifestation of the primary tumor for months or even years. In patients with chronic, recalcitrant lesions of eyelids or conjunctiva, especially if accompanied by loss of eyelashes, a primary or secondary malignancy should be excluded by early biopsies and histopathological examination.
一名50岁的白人男性自1989年1月起就抱怨其右眼睑“发炎”。1990年6月，他因胃腺癌接受了胃切除术。1990年8月，他的右眼出现上、下眼睑无痛性、坚实的浸润，上眼睑溃疡和睫毛脱落，以及内侧球结膜上皮下红色增厚。右上眼睑和鼻侧球结膜活检显示，眼睑和结膜活检均为转移性低分化胃腺癌（印戒细胞癌）。肿瘤细胞中检测到癌胚抗原（CEA）。电子显微镜检查显示肿瘤细胞具有分泌活性迹象。尽管眼睑和结膜转移罕见，但它们可能在原发性肿瘤临床表现出现前数月甚至数年就已发生。对于眼睑或结膜有慢性、顽固性病变的患者，尤其是伴有睫毛脱落的情况，应通过早期活检和组织病理学检查排除原发性或继发性恶性肿瘤。
