Siegel Diane T, Szalai Eszter, Wells Jill R, Grossniklaus Hans E
Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA.
Department of Pathology, Emory University School of Medicine, Atlanta, Georgia, USA.
Ocul Oncol Pathol. 2018 Nov;4(6):381-387. doi: 10.1159/000487007. Epub 2018 Feb 23.
The purpose of the study is to describe the clinical history and histopathologic findings of three cases of scleral thinning after lamellar scleral flap, including one case with confirmed extraocular tumor extension.
The medical records and pathology specimens of three patients with scleral thinning after biopsy and plaque brachytherapy and lamellar scleral flap performed during a transscleral biopsy were reviewed.
The first two patients developed scleral thinning and visible pigmentation, but had tumors that were regressing in size on ultrasound. The two patients were followed by serial observation. The third patient exhibited scleral thinning and evidence of tumor growth on ultrasound, raising the suspicion for extraocular tumor extension. Histopathologic examination of the enucleated eye confirmed extrascleral tumor extension and showed necrotic and intact melanoma with associated pigmented macrophages.
Patients with scleral flaps created for biopsy of uveal melanoma are at risk for scleral thinning and extrascleral extension of tumor recurrence through the flap.
本研究旨在描述三例板层巩膜瓣术后巩膜变薄的临床病史及组织病理学表现，其中一例确诊为眼外肿瘤扩展。
回顾了三例经巩膜活检及斑块近距离放疗和板层巩膜瓣术后出现巩膜变薄患者的病历及病理标本。
前两名患者出现巩膜变薄及可见色素沉着，但超声显示肿瘤大小在缩小。对这两名患者进行了连续观察。第三名患者出现巩膜变薄且超声显示有肿瘤生长迹象，怀疑有眼外肿瘤扩展。摘除眼球的组织病理学检查证实存在巩膜外肿瘤扩展，并显示有坏死及完整的黑色素瘤，伴有相关色素巨噬细胞。
因葡萄膜黑色素瘤活检而制作巩膜瓣的患者有巩膜变薄及肿瘤通过巩膜瓣复发并扩展至巩膜外的风险。
