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[虹膜黑色素瘤的临床体征与鉴别诊断]

[Clinical signs and differential diagnosis of iris melanoma].

作者信息

Tóth Jenô

机构信息

Szemészeti Osztály, Fejér Megyei Szent György Kórház, Székesfehérvár 8000, Hungary.

出版信息

Magy Onkol. 2005;49(2):153-5, 158-9. Epub 2005 Oct 24.

Abstract

Iris melanoma is the rarest type of uveal melanomas. Only 4-5% of uveal melanomas occur on the iris. Although the iris can be easily examined due to its location, differentiation of melanocytic malformations such as naevi or melanomas is difficult for the examiner. According to publications by Rones and Zimmermann, histological examinations showed 22% of tumors to be malignant and 78% to be benign. This lead to iridectomy and iridocyclectomy as therapeutic solutions to gain ground over enucleation. Follow-up of the clinical signs, transillumination, ultrasonic biomicroscopy, iris fluorescein angiography and photo-documentation of the clinical signs can be of great help in diagnosis of pigmented iris tumours. Growth of the tumour, secondary glaucoma, hyphaema, significant vascularisation of the tumour and increasing extent of pigmentation can be signs of malignant behaviour.

摘要

虹膜黑色素瘤是葡萄膜黑色素瘤中最罕见的类型。仅4%-5%的葡萄膜黑色素瘤发生于虹膜。尽管虹膜因其位置易于检查,但检查者很难区分诸如痣或黑色素瘤等黑素细胞畸形。根据罗内斯和齐默尔曼的出版物,组织学检查显示22%的肿瘤为恶性,78%为良性。这使得虹膜切除术和虹膜睫状体切除术作为治疗方案逐渐取代眼球摘除术。临床体征随访、透照法、超声生物显微镜检查、虹膜荧光血管造影以及临床体征的照片记录对色素性虹膜肿瘤的诊断有很大帮助。肿瘤生长、继发性青光眼、前房积血、肿瘤显著血管化以及色素沉着范围增加可能是恶性行为的迹象。

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