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[结膜肿瘤的鉴别诊断与治疗选择]

[Differential diagnosis and treatment options for conjunctival tumors].

作者信息

Holbach L M, Pogorelov P, Kruse F E

机构信息

Augenklinik mit Poliklinik der Universität Erlangen-Nürnberg, Schwabachanlage 6, 91054, Erlangen.

出版信息

Ophthalmologe. 2007 Jun;104(6):521-38; quiz 538. doi: 10.1007/s00347-007-1551-8.

Abstract

The diagnostic classification of most conjunctival tumors is based on case history, inspection, and examination with the slit lamp microscope. Further imaging procedures are rarely indicated when malignant processes are not circumscribed. Clinical classification then also includes palpation and echographic examination of regional lymph nodes. Pigmented and nonpigmented melanocytic nevi are the most frequent conjunctival tumors. An important practical biomicroscopic cardinal symptom of the most frequent nevi is the presence of epithelial pseudocysts. Essential in practice is the histopathological confirmation of the clinical diagnosis, e.g., distinguishing between nonpigmented melanomas and sebaceous gland carcinomas with a pagetoid growth pattern or squamous cell carcinomas. Depending on the course and findings, the following therapeutic measures can be indicated: cryotherapy, chemotherapy, radiotherapy, modified enucleation, orbital exenteration, or a combination of different methods.

摘要

大多数结膜肿瘤的诊断分类基于病史、检查以及裂隙灯显微镜检查。当恶性病变范围不局限时,很少需要进一步的影像学检查。临床分类还包括对区域淋巴结的触诊和超声检查。色素性和非色素性黑素细胞痣是最常见的结膜肿瘤。最常见痣的一个重要的实际生物显微镜主要症状是上皮性假性囊肿的存在。在实践中,临床诊断的组织病理学确认至关重要,例如区分非色素性黑色素瘤与具有派杰样生长模式的皮脂腺癌或鳞状细胞癌。根据病程和检查结果,可采取以下治疗措施:冷冻疗法、化疗、放疗、改良眼球摘除术、眼眶内容剜除术或不同方法的联合应用。

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