Sahu Sabin, Bhutia Tshering Wangchuk, Shrestha Varun, Singh Sanjay Kumar, Puri Lila Raj
Sagarmatha Choudhary Eye Hospital, Siraha, Nepal.
GMS Ophthalmol Cases. 2019 May 31;9:Doc19. doi: 10.3205/oc000108. eCollection 2019.
Choroidal melanoma is a relatively rare tumour with a poor prognosis, though it is the most common primary malignancy of the eye among adults. Choroidal melanoma has been reported to present as acute angle closure glaucoma, secondary glaucoma, chronic uveitis, cataract, and staphyloma. We report a case of a28-year-old male presenting with features of neovascular glaucoma in the right eye and having initially been treated with anti-glaucoma medications. However, ultrasonography revealed a mushroom-shaped, elevated, solid lesion with low to moderate internal reflectivity and regular internal structure suggestive of choroidal melanoma. Histopathological examination along with the immunohistochemistry studies of the lesion following enucleation of the eye confirmed the diagnosis of malignant choroidal melanoma. We highlight with this case that large choroidal melanoma may rarely present with features of neovascular glaucoma. The etiology of neovascular glaucoma should be investigated carefully and a potentially life-threatening intraocular tumour should be excluded, although it is a rare presentation.
脉络膜黑色素瘤是一种相对罕见且预后较差的肿瘤，尽管它是成年人中最常见的眼部原发性恶性肿瘤。据报道，脉络膜黑色素瘤可表现为急性闭角型青光眼、继发性青光眼、慢性葡萄膜炎、白内障和巩膜葡萄肿。我们报告一例28岁男性，右眼表现为新生血管性青光眼的特征，最初接受了抗青光眼药物治疗。然而，超声检查显示一个蘑菇状、隆起的实性病变，内部反射率低至中等，内部结构规则，提示脉络膜黑色素瘤。眼球摘除术后对病变进行组织病理学检查及免疫组织化学研究，确诊为恶性脉络膜黑色素瘤。我们通过这个病例强调，大的脉络膜黑色素瘤很少表现为新生血管性青光眼的特征。尽管这种表现罕见，但应仔细调查新生血管性青光眼的病因，并排除潜在的危及生命的眼内肿瘤。
