Saeed Muhammad Usman, Chang Bernard Yp, Anand Seema, Chakrabarty Arundhati
Department of Ophthalmology, Clarendon Wing, Leeds General Infirmary, Leeds, UK.
Orbit. 2007 Jun;26(2):129-31. doi: 10.1080/01676830600974902.
To report a rare ocular tumor discovered incidentally after evisceration of a painful blind eye.
Observational case report.
A 67-year-old Caucasian lady presented for elective evisceration of chronically irritable phthisical right eye. A history of bilateral retinal detachment surgery 34 years prior followed by phthisis of the right eye was noted. The patient was a smoker but otherwise fit and well. Intra-operatively, the ocular contents were felt to be unusual with hard deeply pigmented lumps being present in the eviscerated tissue. The specimen was sent for histopathology. This was reported as a primary adenocarcinoma of the retinal pigment epithelium after expert histological opinion. The possibilities of a secondary adenocarcinoma with possible primary sites as lung, breast or kidney were ruled out by immuno-histochemical techniques. The patient underwent extensive systemic screening including a whole body CT scan. Exhaustive investigations have not found any other tumor site.
In the absence of a recognizable source of metastasis, a diagnosis of primary ocular adenocarcinoma has been made with retinal pigment epithelium being the possible site of origin. Literature review shows that primary ocular adenocarcinoma arising from neuroepithelium is a rare but recognized occurrence especially in longstanding blind eyes. This case highlights the importance of routine histopathological examination of eviscerated ocular contents, especially in long standing blind eyes.
报告一例在摘除疼痛性盲眼后偶然发现的罕见眼部肿瘤。
观察性病例报告。
一名67岁的白人女性因择期摘除慢性刺激性失明的右眼就诊。注意到34年前有双侧视网膜脱离手术史，随后右眼眼球痨。患者吸烟，但其他方面健康状况良好。术中，感觉眼内容物异常，摘除组织中有坚硬的深色肿块。标本送去做组织病理学检查。经专家组织学诊断为视网膜色素上皮原发性腺癌。免疫组化技术排除了可能的原发部位为肺、乳腺或肾脏的继发性腺癌。患者接受了包括全身CT扫描在内的广泛全身筛查。详尽的检查未发现任何其他肿瘤部位。
在没有可识别的转移来源的情况下，诊断为原发性眼腺癌，视网膜色素上皮可能是起源部位。文献综述表明，起源于神经上皮的原发性眼腺癌是一种罕见但已被认识到的情况，尤其是在长期失明的眼睛中。该病例突出了对摘除的眼内容物进行常规组织病理学检查的重要性，尤其是在长期失明的眼睛中。
