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[浅表恶性肿瘤的当前治疗方法]

[Current Therapies in Superficial Malignant Tumors].

作者信息

Scholz Simone Luisa, Eckstein Anja, Dekowski Dirk, Esser Joachim, Westekemper Henrike, Steuhl Klaus P

机构信息

Zentrum für Augenheilkunde, Universitätsklinikum Essen, Essen.

Orthoptik, Universitäts-Augenklinik Essen, Essen.

出版信息

Laryngorhinootologie. 2019 Oct;98(10):685-694. doi: 10.1055/a-0960-6490. Epub 2019 Oct 14.

Abstract

This article is a review of diagnostic and therapeutic possibilities in common epibulbar malignant tumors, such as basal cell carcinoma, conjunctival lymphoma, squamous cell carcinoma and conjunctival melanoma. Most importantly, for every tumor patient there is a detailed anamnesis, split lamp examination and photo documentation. Further regular controls after therapy are required due to the risk of recurrences. Basal cell carcinoma is the most common tumor of the periocular skin, divided into three subtypes (nodular, superficial and morphea). The treatment consists of total excision with a sufficient safety margin.The most common tumor of the orbital and ocular adnexa are lymphoma. They can appear primary or secondary, as lymphatic system disease. The gold standard therapy is a percutaneous irradiation.Squamous cell carcinoma and its precancerous stages (CIN I-III) are frequently diagnosed on the conjunctiva. A complete tumor excision is required, but sometimes it is not possible due to large tumor growth. Therefore, an adjuvant therapy with mitomycin C eyedrops, brachytherapy with ruthenium plaque or proton radiotherapy is required.Conjunctival melanoma is a rare, but life-threatening disease. Melanosis with atypia has a high risk for degeneration and requires further treatment with mitomycin C eyedrops. In cases of malignant tumor growth, an excision with a non-touch technique and adjuvant therapy with brachy or proton irradiation should be applied.

摘要

本文是对常见眼球表面恶性肿瘤(如基底细胞癌、结膜淋巴瘤、鳞状细胞癌和结膜黑色素瘤)诊断和治疗可能性的综述。最重要的是,对于每一位肿瘤患者,都要进行详细的病史采集、裂隙灯检查和拍照记录。由于存在复发风险,治疗后需要进一步定期复查。基底细胞癌是眼周皮肤最常见的肿瘤,分为三种亚型(结节型、表浅型和硬斑病样型)。治疗方法是进行有足够安全切缘的完整切除。眼眶和眼附属器最常见的肿瘤是淋巴瘤。它们可原发或继发出现,作为淋巴系统疾病。金标准治疗是经皮照射。鳞状细胞癌及其癌前阶段(CIN I - III)常在结膜处被频繁诊断出来。需要完整切除肿瘤,但有时由于肿瘤生长过大而无法做到。因此,需要用丝裂霉素C滴眼液进行辅助治疗、用钌板近距离放疗或质子放疗。结膜黑色素瘤是一种罕见但危及生命的疾病。非典型黑色素沉着发生恶变的风险很高,需要用丝裂霉素C滴眼液进一步治疗。在恶性肿瘤生长的情况下,应采用非接触技术切除并辅以近距离或质子照射进行辅助治疗。

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