Coutts Michael A, Borthwick Nicola J, Hungerford John L, Cree Ian A
Cellular Pathology, Preston Hall Hospital, Maidstone and Tunbridge Wells NHS Trust, Kent, UK.
Pathol Oncol Res. 2006;12(3):184-7. doi: 10.1007/BF02893367. Epub 2006 Sep 23.
Uveal melanoma differs from cutaneous melanoma in many ways, including its pattern of metastasis, and exhibits latency with clinical evidence of metastasis sometimes appearing many years after primary diagnosis. Most patients develop metastasis within the liver, but some may present with metastasis to other sites. We report a case of uveal melanoma that presented with post-menopausal bleeding due to metastasis. Further investigation revealed widespread metastatic disease and the patient was not fit for chemotherapy. She died two months after presentation: autopsy revealed metastases in many sites, including the uterus, right ovarian fibroma, kidney, mesentery, liver, lung, thyroid, bone marrow and skin. The immediate cause of death was cardiac tamponade due to a malignant effusion secondary to cardiac metastasis. This case illustrates the widespread metastatic potential of uveal melanoma and highlights the potential for unusual presentation of metastatic disease from this eye tumor.
葡萄膜黑色素瘤在许多方面与皮肤黑色素瘤不同，包括其转移模式，并且具有潜伏期，转移的临床证据有时在初次诊断后许多年才出现。大多数患者在肝脏发生转移，但有些患者可能出现转移至其他部位。我们报告一例葡萄膜黑色素瘤患者，因转移导致绝经后出血。进一步检查发现广泛的转移性疾病，且患者不适合化疗。她在就诊两个月后死亡：尸检显示多处转移，包括子宫、右卵巢纤维瘤、肾脏、肠系膜、肝脏、肺、甲状腺、骨髓和皮肤。直接死因是心脏转移继发恶性积液导致的心包填塞。该病例说明了葡萄膜黑色素瘤广泛的转移潜能，并突出了这种眼部肿瘤转移性疾病不寻常表现的可能性。
