Filloy Alejandro, Caminal J Maria, Bruzual Maria C, Varela Maria Del M, Gomà Montserrat
University Hospital of Bellvitge - IDIBELL, University of Barcelona, L'Hospitalet de Llobregat , Barcelona , Spain.
Semin Ophthalmol. 2014 May;29(3):163-5. doi: 10.3109/08820538.2013.801496. Epub 2013 Jul 19.
Choroidal melanoma may arise de novo or transformed from a previously existing nevus. Modern cytogenetical techniques allow us to determine and classify the genetic aberrations of such tumors. We report a case of a 55-year-old man presenting a malignant transformation of a previously known choroidal nevus in his right eye. Nine years earlier, that same eye was treated with brachytherapy for a malignant melanoma. Enucleation was indicated followed by histopathological study as well as gene mutation analysis of the tumor cells. The second melanoma was anatomically independent from the first one, discarding the possibility of spreading. Cytogenetical study resulted in significant loss of the short arm of chromosome 1 and the long arm of chromosome 3. Only 21 cases of multiple uveal melanoma in the same eye are reported in the literature. To our knowledge this is the first cytogenetical report of one of such cases. It highlights the importance of follow-up in these patients, especially when risk factors like a choroidal naevus are present.
脉络膜黑色素瘤可原发产生,也可由先前存在的痣恶变而来。现代细胞遗传学技术使我们能够确定此类肿瘤的基因畸变并进行分类。我们报告一例55岁男性病例,其右眼先前已知的脉络膜痣发生了恶变。九年前,同一只眼睛曾因恶性黑色素瘤接受近距离放射治疗。随后进行了眼球摘除术,并对肿瘤细胞进行了组织病理学研究以及基因突变分析。第二个黑色素瘤在解剖学上与第一个独立,排除了转移的可能性。细胞遗传学研究结果显示1号染色体短臂和3号染色体长臂有明显缺失。文献中仅报道了21例同一只眼睛发生多发性葡萄膜黑色素瘤的病例。据我们所知,这是此类病例的首篇细胞遗传学报告。它凸显了对这些患者进行随访的重要性,尤其是当存在脉络膜痣等危险因素时。