Chiang Wei-Yu, Lin Jui-Wei, Yang I-Hui, Kuo Hsi-Kung
Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Department of Pathology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
APMIS. 2015 Jun;123(6):540-5. doi: 10.1111/apm.12384. Epub 2015 Apr 23.
We report a literature review and detailed evaluation of a rare case of posterior choroidal leiomyoma to emphasize the importance of differentiating this from other choroidal tumors. A 30-year-old male presented with variable blurred vision in his right eye secondary to a choroidal tumor. Clinical examinations were performed including fundus photography, optical coherence tomography, B scans, fluorescein and indocyanine green angiography, computed tomography, and magnetic resonance imaging. Preoperative examination revealed a suspected choroidal melanoma and enucleation was performed. However, a definitive diagnosis of choroidal leiomyoma was made following postoperative pathological light microscopy and immunohistochemical studies. Published case reports were collected and the common characteristics and distinctive features were compared with the current case. Posterior choroidal leiomyoma was summarized from the literature, and beneficial information for diagnosis and treatment was obtained. In conclusion, posterior choroidal leiomyoma is rare and should be differentiated from amelanotic melanomas. Despite the benign nature, an explanation regarding the rare incidence and difficult diagnosis of posterior choroidal leiomyoma must be provided to patients, prior to enucleation or detrimental treatment.
我们报告了一例罕见的脉络膜后平滑肌瘤的文献综述及详细评估,以强调将其与其他脉络膜肿瘤相鉴别的重要性。一名30岁男性因脉络膜肿瘤导致右眼视力模糊且程度不一。进行了包括眼底照相、光学相干断层扫描、B超扫描、荧光素和吲哚菁绿血管造影、计算机断层扫描及磁共振成像在内的临床检查。术前检查提示疑似脉络膜黑色素瘤,遂行眼球摘除术。然而,术后病理光学显微镜检查及免疫组化研究后确诊为脉络膜平滑肌瘤。收集已发表的病例报告,并将其共同特征及独特特点与当前病例进行比较。从文献中总结出脉络膜后平滑肌瘤的相关情况,获取了对诊断和治疗有益的信息。总之,脉络膜后平滑肌瘤罕见,应与无色素性黑色素瘤相鉴别。尽管其性质为良性,但在进行眼球摘除术或有害治疗前,必须向患者说明脉络膜后平滑肌瘤发病率低及诊断困难的情况。