Singh Dig Vijay, Gupta Vishali, Singh Shrawan Kumar
Department of Urology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Urol Int. 2016;96(3):367-9. doi: 10.1159/000351925. Epub 2013 Aug 21.
The aim of this report is to contribute to the clinical understanding of choroid metastasis from testicular carcinoma. A young male patient presented with loss of vision in his left eye with ptosis and proptosis. Fundoscopy revealed bullous retinal detachment with dark hazy vitreous. The preliminary diagnosis of choroid carcinoma with vitreous involvement was made by an ophthalmologist. Later in the physical examination, there was a firm painless left testicular swelling. Testicular tumor markers were raised. Based on ultrasonography, MRI and PET-CT, a clinical diagnosis of left testicular carcinoma metastasizing to the left choroid and vitreous was made. A mixed germ cell tumor was reported on histopathological examination. After cisplatin-based chemotherapy, serum tumor markers normalized and vision improved. Exceptional choroidal and vitreous metastases with absence of other visceral and bony involvement constituted the presenting sign. Although rare, testicular carcinoma must be considered to metastasize to the eye, especially if loss of vision is the chief complaint.
本报告旨在促进对睾丸癌脉络膜转移的临床理解。一名年轻男性患者出现左眼视力丧失伴上睑下垂和眼球突出。眼底检查发现视网膜大泡状脱离,玻璃体混浊。眼科医生初步诊断为脉络膜癌伴玻璃体受累。在后续体格检查中,发现左侧睾丸有一个质地硬、无痛的肿块。睾丸肿瘤标志物升高。基于超声、磁共振成像(MRI)和正电子发射断层显像-X线计算机体层成像(PET-CT),临床诊断为左侧睾丸癌转移至左侧脉络膜和玻璃体。组织病理学检查报告为混合性生殖细胞肿瘤。基于顺铂的化疗后,血清肿瘤标志物恢复正常,视力改善。脉络膜和玻璃体的罕见转移且无其他内脏和骨转移构成了主要表现。尽管罕见,但睾丸癌转移至眼部必须予以考虑,尤其是以视力丧失为主诉时。