Cozzi Salvatore, Escarpa Andrea Slocker, Parra Daniel Lorenzo, Jamal Dina Najjari, Mitjana Josep Maria Caminal, R Josep Maria Piulats, Edo Ferran Guedea, Miguelez Cristina Gutierrez
Radiation Oncology Department, University Hospital "Maggiore della Caritá", Novara, Italy.
Radiation Oncology Department, Catalan Institute of Oncology, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
Rep Pract Oncol Radiother. 2019 Jan-Feb;24(1):56-59. doi: 10.1016/j.rpor.2018.10.002. Epub 2018 Nov 12.
Uveal melanoma is a rare tumour caused by genetic factors and alterations in the immune response. Inflammatory bowel disease (IBD) is a multifactorial chronic inflammatory disorder characterized by an inappropriate or excessive immune response. The two main types of IBD are Crohn's disease (CD) and ulcerative colitis (UC). A diagnosis of IBD and the use of immunosuppressive drugs are both independently associated with an increased risk of developing skin melanoma. The association between IBD and uveal melanoma (UM) has not been previously described.
Two young Caucasian men, aged 24 and 28, developed UM 3 and 15 years, respectively, after being diagnosed with IBD. Both received long-term treatment with immunomodulatory drugs, with periodic switching among the drugs due to the refractory nature of IBD. In both cases, melanoma was treated by brachytherapy with iodine-125 COMS plaque implant at a dose of 75 Gy.
Chronic inflammation can promote cell proliferation and growth. The use of immunomodulatory drugs is associated with an increased risk of developing melanoma and non-melanoma skin cancer. The two patients described in this report both had long-standing IBD treated with immunomodulatory drugs. It seems reasonable to suggest that these two factors may have promoted the development of uveal melanoma. More studies are warranted to investigate and confirm this possible association.
葡萄膜黑色素瘤是一种由遗传因素和免疫反应改变引起的罕见肿瘤。炎症性肠病（IBD）是一种多因素慢性炎症性疾病，其特征是免疫反应不当或过度。IBD的两种主要类型是克罗恩病（CD）和溃疡性结肠炎（UC）。IBD的诊断和免疫抑制药物的使用均与患皮肤黑色素瘤的风险增加独立相关。IBD与葡萄膜黑色素瘤（UM）之间的关联此前尚未见报道。
两名年轻的白种男性，年龄分别为24岁和28岁，在被诊断为IBD后分别于3年和15年后患上了UM。两人均接受了免疫调节药物的长期治疗，由于IBD的难治性，药物需定期更换。在这两个病例中，黑色素瘤均采用碘-125 COMS斑块植入近距离放射治疗，剂量为75 Gy。
慢性炎症可促进细胞增殖和生长。使用免疫调节药物与患黑色素瘤和非黑色素瘤皮肤癌的风险增加有关。本报告中描述的两名患者均患有长期IBD并接受了免疫调节药物治疗。认为这两个因素可能促进了葡萄膜黑色素瘤的发生似乎是合理的。需要更多的研究来调查和证实这种可能的关联。
