未被怀疑的黄斑脉络膜黑色素瘤中的出血性并发症。
Hemorrhagic complication in an unsuspected macular choroidal melanoma.
作者信息
Chan Wai-Man, Kwok Alvin K H, Liu David T L, Choi Paul C L, Lam Sze-Wing, Lam Dennis S C
机构信息
Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong.
出版信息
Am J Ophthalmol. 2004 Mar;137(3):574-7. doi: 10.1016/j.ajo.2003.08.044.
PURPOSE
To report a rare presentation of a hemorrhagic complication in a patient with unsuspected macular choroidal melanoma.
DESIGN
Interventional case report.
METHODS
A 32-year-old Chinese woman presented with disturbance of her left central vision. A hemorrhagic mass at the macula was noticed that was evacuated by submacular surgery.
RESULTS
The mass expanded rapidly into a mushroom configuration after surgery. Fine-needle aspiration confirmed the diagnosis of malignant choroidal melanoma, and enucleation followed. Histology demonstrated moderately large epithelioid tumor cells with prominent nucleoli. The sclera was intact, and the optic nerve was not involved. The patient has been followed for 5 years without signs of local recurrence or metastasis.
CONCLUSION
We should be alert for atypical presentations of choroidal melanoma. Unnecessary or inadvertent surgical intervention may induce tumor growth and subsequent local spread or metastasis.
目的
报告一例未被怀疑患有黄斑脉络膜黑色素瘤患者出现出血性并发症的罕见病例。
设计
介入性病例报告。
方法
一名32岁中国女性出现左眼中心视力障碍。发现黄斑处有一个出血性肿块，通过黄斑下手术将其清除。
结果
术后肿块迅速扩展成蘑菇状。细针穿刺确诊为脉络膜恶性黑色素瘤，随后进行了眼球摘除术。组织学显示有中等大小的上皮样肿瘤细胞，核仁明显。巩膜完整，视神经未受累。该患者已随访5年，无局部复发或转移迹象。
结论
我们应警惕脉络膜黑色素瘤的非典型表现。不必要或不经意的手术干预可能会促使肿瘤生长并随后发生局部扩散或转移。
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