伴有巩膜炎和脉络膜积液的坏死性脉络膜黑色素瘤。
Necrotic choroidal melanoma with scleritis and choroidal effusion.
作者信息
Palamar Melis, Thangappan Archana, Shields Carol L, Ehya Hormoz, Shields Jerry A
机构信息
Ocular Oncology Service, Wills Eye Institute, Thomas Jefferson University, Philadelphia, PA 19107, USA.
出版信息
Cornea. 2009 Apr;28(3):354-6. doi: 10.1097/ICO.0b013e3181875463.
PURPOSE
To report a case of a choroidal melanoma that presented with painful scleritis and choroidal effusion.
METHODS
Interventional case report with cytopathologic correlation.
RESULTS
A 78-year-old otherwise healthy woman presented with sudden, severe painful ocular inflammation and marked injection of the right eye over a 3-day period, consistent with scleritis. Upon referral, 360 degrees of scleral and conjunctival injection and peripheral choroidal effusion were found. In addition, a solid hemorrhagic, choroidal mass was evident, suspicious for melanoma. Fine needle aspiration biopsy of the choroidal mass confirmed necrotic melanoma. The melanoma was treated with iodine 125 plaque radiotherapy, and during surgery, the temporal sclera was markedly edematous and the orbital tissue was fibrotic, presumed related to inflammation. Two months after radiotherapy, the scleritis and choroidal effusion had resolved.
CONCLUSION
Uveal effusion can rarely occur with uveal melanoma, particularly when the tumor is necrotic.
目的
报告1例表现为疼痛性巩膜炎和脉络膜积液的脉络膜黑色素瘤病例。
方法
伴有细胞病理学相关性的介入性病例报告。
结果
一名78岁、其他方面健康的女性在3天内出现突发、严重的疼痛性眼部炎症和右眼明显充血，符合巩膜炎表现。转诊后，发现360度巩膜和结膜充血以及周边脉络膜积液。此外，可见一个实性出血性脉络膜肿物，怀疑为黑色素瘤。脉络膜肿物细针穿刺活检证实为坏死性黑色素瘤。该黑色素瘤采用碘125敷贴放疗治疗，手术过程中，颞侧巩膜明显水肿，眼眶组织纤维化，推测与炎症有关。放疗后2个月，巩膜炎和脉络膜积液消退。
结论
葡萄膜黑色素瘤很少伴有葡萄膜积液，特别是当肿瘤坏死时。
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