Kiuchi Katsuji, Kimoto Takashi, Takahashi Kanji, Shima Chieko, Nishimura Tetsuya, Matsumura Miyo
Department of Ophthalmology, Kansai Medical University, Takii Hospital, Osaka, Japan.
Nippon Ganka Gakkai Zasshi. 2007 Sep;111(9):735-40.
Metastasis of a malignant tumor to the iris is rare. We treated a patient with such a metastasis from esophageal cancer.
A 58-year-old man who had had an operation for squamous esophageal cancer complained of conjunctival injection affecting the left eye. On examination, visual acuity in both eyes was 1.2, and intraocular pressure (IOP) in both eyes was 18 mmHg. A grayish tumor with irregular contours was found on the surface of the iris of the left eye at 2 o'clock, and cottonlike material was pooled in the anterior chamber. No metastases elsewhere in the body were clinically evident. After IOP rose to 34 mmHg accompanied by ocular pain, we performed a peripheral iridectomy for diagnosis. Pathologic findings indicated squamous esophageal cancer metastatic to the iris. Metastases to lung and liver were found by computed tomography shortly after hospitalization. Radiotherapy 40 Gy was applied to the iris tumor. IOP then fell, and ocular pain disappeared.
Metastasis of a squamous esophageal cancer to the iris can resemble a hypopyon. Radiotherapy was effective in this patient.
恶性肿瘤转移至虹膜罕见。我们治疗了一名患有食管癌转移至虹膜的患者。
一名58岁男性,曾接受过食管鳞状癌手术,主诉左眼结膜充血。检查发现,双眼视力均为1.2,双眼眼压(IOP)均为18 mmHg。在左眼虹膜表面2点钟位置发现一个轮廓不规则的灰色肿瘤,前房有棉絮状物质积聚。临床上未发现身体其他部位有转移。在眼压升至34 mmHg并伴有眼痛后,我们进行了周边虹膜切除术以明确诊断。病理结果显示为食管鳞状癌转移至虹膜。住院后不久,通过计算机断层扫描发现肺部和肝脏有转移。对虹膜肿瘤进行了40 Gy的放射治疗。随后眼压下降,眼痛消失。
食管鳞状癌转移至虹膜可类似前房积脓。放射治疗对该患者有效。