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获得性无色素睫状上皮腺瘤:5例分析

Acquired adenoma of the nonpigmented ciliary epithelium: analysis of five cases.

作者信息

Yan Jianhua, Liu Xianyong, Zhang Ping, Li Yongping

机构信息

The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, 54 Xieli Nan Road, Guangzhou, 510060, The People's Republic of China,

出版信息

Graefes Arch Clin Exp Ophthalmol. 2015 Apr;253(4):637-44. doi: 10.1007/s00417-014-2928-4. Epub 2015 Jan 22.

Abstract

PURPOSE

Adenoma of the non-pigmented ciliary epithelium (ANPCE) is extremely rare. The aim of this study is to present our experience in treating this rare entity and to determine the long-term surgical outcomes of local tumor resection (partial iridocyclectomy with lamellar sclerouvectomy) in five cases of ANPCE in China.

PATIENTS AND METHODS

The medical data of four women and one man ranging in age from 28 to 46 years (median, 38 years) with ANPCE were reviewed retrospectively at the Zhongshan Ophthalmic Center of Sun Yat-sen University, China. All patients had received local tumor resection and the diagnosis was confirmed by histopathological examination.

RESULTS

All five cases experienced blurred vision. The right eye was affected in four cases and the left in one. Slit-lamp biomicroscopy revealed a nodular, non-pigmented, gray-white mass with a slightly irregular surface. Tumor invasion through the peripheral iris was observed in two patients, two patients had multiple iris or ciliary cysts, and one patient had a partially bloodstained cornea. All tumors transmitted light readily. Ultrasound biomicroscopy showed a middle- or hyper-echoic solid mass in the ciliary body. MRI examination showed the tumor hyperintense to vitreous on T1WI and hypointense to vitreous on T2WI. Local resection was performed in all cases. After a median of 5.0 years of follow-up, no tumor recurrence was present in any of the cases and all involved eyes were saved. The visual acuity improved seven lines in three cases, decreased one line in one case, and vision was lost in one case.

CONCLUSIONS

ANPCE often presents in adults as gray-white in color, with an irregular and sometimes multilobulated surface. The tumor transmits light well. Local resection of the mass generally provides the patient with useful vision. Recurrence after surgical removal is unlikely.

摘要

目的

无色素睫状上皮腺瘤(ANPCE)极为罕见。本研究旨在分享我们治疗这一罕见疾病的经验,并确定在中国5例ANPCE患者中进行局部肿瘤切除(板层巩膜脉络膜切除术联合部分虹膜睫状体切除术)的长期手术效果。

患者与方法

回顾性分析中山大学中山眼科中心4例女性和1例男性ANPCE患者的医学资料,年龄范围为28至46岁(中位数38岁)。所有患者均接受了局部肿瘤切除,诊断经组织病理学检查确诊。

结果

所有5例患者均有视力模糊。4例患右眼,1例患左眼。裂隙灯生物显微镜检查显示为结节状、无色素、灰白色肿物,表面略不规则。2例患者观察到肿瘤侵犯周边虹膜,2例患者有多个虹膜或睫状体囊肿,1例患者角膜部分血染。所有肿瘤均透光良好。超声生物显微镜检查显示睫状体有中等回声或高回声实性肿物。MRI检查显示肿瘤在T1WI上相对于玻璃体呈高信号,在T2WI上相对于玻璃体呈低信号。所有病例均行局部切除术。中位随访5.0年后,所有病例均无肿瘤复发,所有受累眼均得以保留。3例患者视力提高7行,1例患者视力下降1行,1例患者视力丧失。

结论

ANPCE在成人中常表现为灰白色,表面不规则,有时呈多叶状。肿瘤透光良好。局部切除肿物一般能为患者保留有用视力。手术切除后 unlikely(此处原文有误,根据语境推测应为unlikely,意为不太可能)复发。

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