Reddy S C, Darnal H K
School of Medicine, University Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
Nepal J Ophthalmol. 2014 Jan;6(11):113-8. doi: 10.3126/nepjoph.v6i1.10783.
Melanoma is a rare malignant tumour in the eye.
To report two cases of malignant melanoma in the eye, one in the conjunctiva and the other in the choroid.
The first case was in a 49-year-old lady who presented with a swelling on the inner side of left upper eyelid. The vision was 6/6. On everting the eyelid, multiple, pigmented, nodular swellings were noted on the tarsal conjunctiva. Excision biopsy confirmed the diagnosis of malignant melanoma of the conjunctiva. A pigmented nodular swelling occurred on the lower bulbar conjunctiva in the same eye one-and-a-half years after the first presentation. There were no secondary nodules in the body. Excision biopsy confirmed malignant melanoma of the conjunctiva. The second case was in a 72-year-old lady who presented with pain and bleeding in the right eye. There was no perception of light. The cornea was hazy and the details behind it could not be seen. There was micro perforation of the cornea with oozing of blood and secondary glaucoma. B-scan ultrasonography of the right eye revealed an intraocular tumour. The histopathology of the enucleated eyeball confirmed the diagnosis of malignant melanoma of the choroid.
In the case of conjunctival melanoma, the occurrence of tumour at multiple sites and absence of recurrence at the original site suggests the possibility of de novo origin of the tumour. Secondary glaucoma and bleeding may be the presenting features of melanoma in the choroid.
黑色素瘤是一种罕见的眼部恶性肿瘤。
报告两例眼部恶性黑色素瘤病例，一例位于结膜，另一例位于脉络膜。
第一例患者为一名49岁女性，左上眼睑内侧出现肿物。视力为6/6。翻开眼睑后，睑结膜可见多个色素沉着的结节状肿物。切除活检确诊为结膜恶性黑色素瘤。首次发病一年半后，同一只眼的球结膜下方出现一个色素沉着的结节状肿物。全身无继发结节。切除活检确诊为结膜恶性黑色素瘤。第二例患者为一名72岁女性，右眼出现疼痛和出血。无光感。角膜混浊，其后部细节无法看清。角膜有微小穿孔，伴有渗血和继发性青光眼。右眼B超检查显示眼内肿瘤。摘除眼球的组织病理学检查确诊为脉络膜恶性黑色素瘤。
对于结膜黑色素瘤病例，肿瘤在多个部位发生且原部位无复发提示肿瘤可能为新发。继发性青光眼和出血可能是脉络膜黑色素瘤的首发症状。
