Krema Hatem, McGowan Hugh, Tanzer Herbert, Simpson Rand, Laperriere Normand
Departments of Ocular & Radiation Oncology, Princess Margaret Cancer Center, University of Toronto, Toronto, ON, Canada.
J Ophthalmic Vis Res. 2013 Jan;8(1):53-7.
To report the clinical and paraclinical features of two patients with orange- colored choroidal metastases in whom the primary cancers have not previously been associated with such lesions.
Orange-colored choroidal lesions were detected on the fundus examination of one patient with metastatic small cell neuroendocrine tumor of the larynx and oropharynx, and in another subject with metastatic alveolar soft part sarcoma of the leg. Although ultrasonographic characteristics of the choroidal masses were comparable to those of choroidal hemangiomas, fluorescein angiography revealed delayed initial fluorescence along with minimal fluorescence in subsequent phases of the angiogram which were in clear distinction from the earlier appearing and progressively intense fluorescence observed with circumscribed choroidal hemangiomas.
Small cell neuroendocrine tumors and alveolar soft part sarcomas should be considered among the differential diagnoses for orange-colored choroidal metastases. Identifying these choroidal lesions could facilitate localizing the occult primary tumor. Fluorescein angiography may differentiate a unifocal orange choroidal metastasis from a circumscribed choroidal hemangioma.
报告两例橙色脉络膜转移瘤患者的临床及辅助检查特征，这两例患者的原发癌此前未被认为会出现此类病变。
在一名患有喉和口咽转移性小细胞神经内分泌肿瘤的患者以及另一名患有腿部转移性肺泡软组织肉瘤的患者的眼底检查中发现了橙色脉络膜病变。虽然脉络膜肿物的超声特征与脉络膜血管瘤相似，但荧光素血管造影显示造影初期荧光延迟，且在造影后续阶段荧光微弱，这与局限性脉络膜血管瘤早期出现且逐渐增强的荧光明显不同。
小细胞神经内分泌肿瘤和肺泡软组织肉瘤应被列入橙色脉络膜转移瘤的鉴别诊断范围。识别这些脉络膜病变有助于隐匿原发肿瘤的定位。荧光素血管造影可区分单灶性橙色脉络膜转移瘤和局限性脉络膜血管瘤。
