Tsuji Masatoshi, Kimura Katsuaki, Tsuji Hiroshi, Goto Masamichi, Yoshikawa Hiroshi, Sakamoto Taiji
Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Science, Kagoshima, Kyushu, Japan.
Jpn J Ophthalmol. 2007 Mar-Apr;51(2):127-30. doi: 10.1007/s10384-006-0404-3. Epub 2007 Apr 6.
To report, we believe for the first time, a histological study of choroidal malignant melanoma treated by carbon ion beam radiotherapy.
A 75-year-old Japanese man was diagnosed as having a choroidal melanoma after undergoing magnetic resonance imaging (MRI). Positron emission tomography (PET) revealed a hot spot in the same location as the intraocular mass seen in MRI. Carbon ion radiotherapy was performed with a total dose of 77 Gy, and the hot spot seen by PET disappeared completely. At 15 months after carbon ion therapy, the eye had to be enucleated because of uncontrollable ocular hypertension. It was examined histologically in serial sections.
A large tumor mass (15 x 12 mm) with high pigmentation was found in the vitreous space. Almost all tumor cells showed necrosis in every section. A small number of intact tumor cells were present at the periphery. The overlying retina did not show any necrosis, but showed mild to moderate gliosis. No intraretinal hemorrhage, lipid deposit, or protein exudate was apparent.
Almost all tumor cells showed necrosis after radiotherapy with a carbon ion beam. However, the effect on the adjacent tissues was determined as minimal in histological analysis.
我们相信这是首次报告关于碳离子束放射治疗脉络膜恶性黑色素瘤的组织学研究。
一名75岁的日本男性在接受磁共振成像（MRI）检查后被诊断为脉络膜黑色素瘤。正电子发射断层扫描（PET）显示在MRI中所见眼内肿块的相同位置有一个热点。进行了总剂量为77 Gy的碳离子放射治疗，PET所见热点完全消失。在碳离子治疗后15个月，因无法控制的高眼压而不得不摘除眼球。对其进行了连续切片的组织学检查。
在玻璃体腔中发现一个大的肿瘤块（15×12 mm），色素沉着较高。几乎所有肿瘤细胞在每个切片中均显示坏死。周边有少量完整的肿瘤细胞。上方的视网膜未显示任何坏死，但显示轻度至中度胶质增生。未发现视网膜内出血、脂质沉积或蛋白渗出。
碳离子束放射治疗后几乎所有肿瘤细胞均显示坏死。然而，在组织学分析中确定对相邻组织的影响最小。
