He Fanglin, Wang Yuxin, Jia Renbin
Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine.
Shanghai Key Laboratory of Orbital Disease and Ocular Oncology, Shanghai, China.
J Craniofac Surg. 2018 Nov;29(8):2128-2130. doi: 10.1097/SCS.0000000000004673.
Malignant melanoma predominantly occurs in whites, and is potentially fatal. Distant metastases often occur in lung, liver, brain, and could occur without prior regional disease. Conjunctival melanoma metastasis to contralateral orbit has never been reported.
A 60-year-old man who underwent a left primary conjunctival neoplasm resection 11 months ago presented for the evaluation of a conjunctival dark-colored mass with a bulging left lower eyelid that directly invaded the orbits bilaterally. A histopathologic examination and immunohistochemistry confirmed metastases from conjunctival melanoma. In addition, the contralateral orbit had metastases without local recurrence after surgery within the authors' department. The patient was given adjuvant therapy (vincristine + nedaplatin + dacarbazine) for 5 cycles, but he died 8 months after surgery.
Malignant conjunctival melanoma may metastasize to the contralateral orbit. A histopathologic evaluation should be mandatory in patients with medical histories of malignancy to differentiate new primary tumors, metastases, and benign tumors.
恶性黑色素瘤主要发生于白种人,且具有潜在致命性。远处转移常发生于肺、肝、脑,且可能在无区域疾病史的情况下出现。结膜黑色素瘤转移至对侧眼眶此前未见报道。
一名60岁男性,11个月前接受了左侧原发性结膜肿物切除术,现因结膜深色肿物伴左下睑膨隆前来评估,该肿物双侧直接侵犯眼眶。组织病理学检查及免疫组化证实为结膜黑色素瘤转移。此外,在作者所在科室,患者对侧眼眶出现转移,术后无局部复发。患者接受了5周期辅助治疗(长春新碱+奈达铂+达卡巴嗪),但术后8个月死亡。
恶性结膜黑色素瘤可能转移至对侧眼眶。对于有恶性肿瘤病史的患者,必须进行组织病理学评估以鉴别新发原发性肿瘤、转移瘤及良性肿瘤。