Fabian Ido Didi, Hildebrand G Darius, Wilson Shaun, Foord Tina, Sagoo Mandeep S
Ocular Oncology Service, Moorfields Eye Hospital, 162 City Road, London, EC1V 2PD, UK.
St. Bartholomew's Hospital, London, UK.
BMC Cancer. 2016 Jul 11;16:447. doi: 10.1186/s12885-016-2496-6.
Intraocular iris rhabdomyosarcoma is extremely rare, and in the 3 cases reported to date occurred as the primary site of tumour growth. We report a case of rhabdomyosarcoma of the foot metastasizing to the iris.
An 18-year-old white female was referred to the London Ocular Oncology Service for management of a metastatic rhabdomyosarcomatous deposit in the iris, a metastasis from alveolar rhabdomyosarcoma of the foot. She was diagnosed nearly 2 years earlier with the primary sarcoma with extensive systemic spread and treated by resection of the foot lesion and chemotherapy, and achieved a partial remission. The left iris deposit was noted while she was receiving systemic chemotherapy, heralding a relapse. However, anterior uveitis and raised intraocular pressure developed and she was referred to our service for further management. A left iris secondary rhabdomyosarcoma deposit was noticed and in addition a lacrimal gland mass, as indicated by ultrasound B scan of the eye and orbit. The patient was treated with external beam radiotherapy to the globe and orbit, but died 2 months after treatment completion.
Rhabdomyosarcoma of the iris is very rare and was previously documented only as a primary malignancy in this location. We report that secondary spread to the iris can also occur, in this case as the first sign of widely disseminated systemic relapse.
眼内虹膜横纹肌肉瘤极为罕见，在迄今报道的3例中均为肿瘤生长的原发部位。我们报告1例足部横纹肌肉瘤转移至虹膜的病例。
一名18岁白人女性因虹膜转移性横纹肌肉瘤沉积物前来伦敦眼肿瘤服务中心就诊，该沉积物是足部肺泡横纹肌肉瘤的转移灶。她在近2年前被诊断为原发性肉瘤并伴有广泛的全身扩散，接受了足部病变切除和化疗，达到部分缓解。在她接受全身化疗期间发现了左侧虹膜沉积物，预示着复发。然而，出现了前葡萄膜炎和眼压升高，她被转诊至我们的科室进行进一步治疗。通过眼部和眼眶的B超检查发现左侧虹膜有继发性横纹肌肉瘤沉积物，此外还有泪腺肿块。患者接受了眼球和眼眶的外照射放疗，但在治疗结束后2个月死亡。
虹膜横纹肌肉瘤非常罕见，以前仅记载为该部位的原发性恶性肿瘤。我们报告了转移至虹膜的情况也可发生，在本病例中是广泛播散的全身复发的首个迹象。
