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[结膜恶性肿瘤]

[Conjunctival malignancies].

作者信息

Auw-Hädrich Claudia, Reinhard Thomas

机构信息

Klinik für Augenheilkunde Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland.

出版信息

Ophthalmologe. 2019 Oct;116(10):989-1004. doi: 10.1007/s00347-019-00978-6.

Abstract

Conjunctival malignancies are rare. However, some of these tumors are among the most aggressive malignancies in ophthalmology and require radical forms of therapy that may lead to blindness or loss of the ipsilateral eye and tumor-associated death. The most relevant primary conjunctival malignancies for oncologists are squamous cell carcinoma, malignant melanoma and malignant lymphoma. Surgical therapy is the primary treatment for squamous cell carcinoma and malignant melanoma. An adjuvant therapy in the form of topical chemotherapy or radiation is necessary in most cases. The isolated malignant lymphoma of the conjunctiva is biopsied excisionally if possible. However, if an incisional biopsy was unavoidable, additional irradiation should be performed; malignant lymphoma generally responds very well to relatively low irradiation doses with a good prognosis quad vitam. More aggressive forms, such as diffuse large cell B‑cell lymphoma or mantle cell lymphoma, must also be treated systemically at an early stage.

摘要

结膜恶性肿瘤较为罕见。然而,其中一些肿瘤是眼科中最具侵袭性的恶性肿瘤,需要采取可能导致失明、同侧眼丧失或肿瘤相关死亡的根治性治疗方式。对肿瘤学家而言,最相关的原发性结膜恶性肿瘤是鳞状细胞癌、恶性黑色素瘤和恶性淋巴瘤。手术治疗是鳞状细胞癌和恶性黑色素瘤的主要治疗方法。在大多数情况下,需要采用局部化疗或放疗形式的辅助治疗。结膜孤立性恶性淋巴瘤若可能应进行切除活检。然而,如果不可避免地进行了切开活检,则应进行额外的放疗;恶性淋巴瘤通常对相对低剂量的放疗反应良好,预后良好。更具侵袭性的类型,如弥漫性大细胞B细胞淋巴瘤或套细胞淋巴瘤,也必须在早期进行全身治疗。

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