Kook Koung Hoon, Park Moon Sung, Yim Hyunee, Lee Sang Yeul, Jang Jae Woo, Grossniklaus Hans E
Department of Ophthalmology, Chronic Inflammatory Disease Research Center, Ajou University School of Medicine, Suwon, South Korea.
Ophthalmologica. 2009;223(4):274-8. doi: 10.1159/000213643. Epub 2009 Apr 22.
A newborn girl presented with massive proptosis of the right eye. Physical and radiologic examination disclosed that the primary orbital mass was confined to the site. A diagnosis of malignant rhabdoid tumor was made by histopathologic examination of an incisional biopsy specimen. Exenteration was performed, and the resection margins were free from tumor cells. However, distant metastasis developed in the liver 1 month after surgery. Despite chemotherapy, the patient died 2 months later due to tumor invasion into the central nervous system, which was confirmed by autopsy. To the best of our knowledge, this is the first case of congenital orbital malignant rhabdoid tumor showing systemic metastasis after exenteration, which suggests the need for aggressive systemic treatment rather than exenteration, even in a case of locally confined tumor.
一名新生女婴出现右眼巨大眼球突出。体格检查和影像学检查显示原发性眼眶肿块局限于该部位。通过切开活检标本的组织病理学检查诊断为恶性横纹肌样瘤。进行了眼球摘除术,切除边缘无肿瘤细胞。然而,术后1个月肝脏出现远处转移。尽管进行了化疗,患者2个月后因肿瘤侵犯中枢神经系统死亡,尸检证实了这一点。据我们所知,这是首例先天性眼眶恶性横纹肌样瘤在眼球摘除术后出现全身转移的病例,这表明即使是局部局限的肿瘤,也需要积极的全身治疗而非眼球摘除术。