*Edward S. Harkness Eye Institute; and †Division of Gynecologic Oncology and ‡Department of Pathology and Cell Biology, Columbia University, New York, New York, U.S.A.
Ophthalmic Plast Reconstr Surg. 2014 May-Jun;30(3):e75-7. doi: 10.1097/IOP.0b013e31829bb2a7.
This case report describes a biopsy-proven metastasis of gestational choriocarcinoma to the medial rectus muscle. Patient evaluation and follow up included comprehensive ophthalmologic history and examination, external and fundus photography, immunohistochemistry preparations of the medial rectus muscle specimen, MRI, ultrasound of the abdomen and pelvis, comprehensive blood tests, and CT scans of the chest, abdomen, and pelvis. The tissue specimen was obtained via a medial perilimbal conjunctival peritomy. MRI revealed a mass intrinsic to the right medial rectus muscle. Immunohistochemical staining confirmed gestational choriocarcinoma metastasis in medial rectus muscle biopsy. The patient showed general and orbital improvement following 7 subsequent cycles of chemotherapy. In conclusion, gestational choriocarcinoma may metastasize to the orbit in addition to the previously reported ocular site, the choroid. A chemotherapy regimen of etoposide, methotrexate, actinomycin-D, cyclophosphamide, and vincristine can effectively treat the intraorbital component of the disease.
本病例报告描述了一例经活检证实的绒癌转移至内直肌。患者评估和随访包括全面的眼科病史和检查、外部和眼底摄影、内直肌标本的免疫组织化学制备、MRI、腹部和骨盆超声、全面的血液检查以及胸部、腹部和骨盆 CT 扫描。组织标本通过内侧缘角膜缘结膜旁切开术获得。MRI 显示右侧内直肌内有一肿块。免疫组织化学染色证实内直肌活检中有绒癌转移。患者在接受 7 个周期的化疗后，全身和眼眶状况均有改善。总之，绒癌除了先前报道的眼内部位脉络膜外，还可能转移到眼眶。依托泊苷、甲氨蝶呤、放线菌素-D、环磷酰胺和长春新碱的化疗方案可以有效地治疗疾病的眶内成分。
