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非典型表现:一名无视觉症状的年轻患者的转移性葡萄膜黑色素瘤

Atypical Presentation: Metastatic Uveal Melanoma in a Young Patient without Visual Complaints.

作者信息

Buiar Pedro Grachinski, de Azevedo Sérgio Jobim

机构信息

Department of Medical Oncology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.

出版信息

Front Oncol. 2017 May 18;7:99. doi: 10.3389/fonc.2017.00099. eCollection 2017.

Abstract

BACKGROUND

Uveal melanoma is a rare and aggressive subtype of melanoma, with singular characteristics that separate it from the most famous cutaneous melanoma. This uncommon condition becomes even rarer if we look at young population. Common chemotherapy regimens does not work with this aggressive disease in its metastatic scenario, and the new armament like targeted and immunotherapies are still looking for more robust evidence.

CASE PRESENTATION

We report a rare case of uveal melanoma in a patient younger than 20 years, with abdominal pain as his initial complaint. He did not present the typical visual symptoms of the primary site because of an auto accident suffered 4 months before the presentation, letting him blind of the eye affected by the tumor development.

CONCLUSION

There is always a possibility of the diagnosis of uveal melanoma in cases with associated isolated hepatic metastases, even in a young population, where this hypothesis is often rejected by the epidemiological frequency of other tumors. This rare case is a useful example.

摘要

背景

葡萄膜黑色素瘤是黑色素瘤的一种罕见且侵袭性亚型,具有独特特征,使其有别于最常见的皮肤黑色素瘤。如果观察年轻人群,这种罕见病症会变得更加罕见。在转移性情况下,常用化疗方案对这种侵袭性疾病无效,而靶向治疗和免疫治疗等新手段仍在寻找更有力的证据。

病例报告

我们报告一例罕见的20岁以下葡萄膜黑色素瘤患者,最初症状为腹痛。由于在就诊前4个月遭遇车祸,他未出现原发部位的典型视觉症状,导致受肿瘤影响的眼睛失明。

结论

即使在年轻人群中,对于伴有孤立性肝转移的病例,也始终存在诊断为葡萄膜黑色素瘤的可能性,尽管在这种情况下,由于其他肿瘤的流行病学发生率,这一假设常被否定。这个罕见病例就是一个很好的例子。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e28e/5435810/d5cf10cada8d/fonc-07-00099-g001.jpg

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