Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Medical Artificial Intelligence Research and Verification Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
BMC Ophthalmol. 2020 May 24;20(1):198. doi: 10.1186/s12886-020-01445-6.
Posterior choroidal leiomyoma is an extremely rare tumor, to our knowledge, less than 10 cases reported in the literature. The definite diagnosis can be confirmed by immunohistochemistry, and local resection is preferable to enucleation for the posterior choroidal leiomyoma.
Two adult Asian women presented with progressive vision loss in their right eyes. Ophthalmic examination revealed an amelanotic dome-shaped choroidal mass located in the fundus with yellowish exudative retinal detachment. Clinical differential diagnosis of a nonpigmented choroidal neoplasm mainly includes amelanotic melanoma, atypical hemangioma, metastatic carcinoma, as well as the rare posterior choroidal leiomyoma. Considering the choroidal lesion was more likely to be a benign tumor, then we performed the treatment of local resection by pars plana vitrectomy and the histopathological examination confirmed the diagnosis of choroidal leiomyoma. The best corrected visual acuity of the patients was more than 20/100 on 6-month follow-up.
From these two posterior choroidal neoplasm cases, we were able to demonstrate local resection by the 23 to 25-gauge mircoinvasive vitrectomy for excision of intraocular tumors is a feasible treatment for choroidal leiomyoma.
脉络膜后平滑肌瘤是一种极其罕见的肿瘤，据我们所知，文献中报道的病例少于 10 例。免疫组织化学可明确诊断，脉络膜后平滑肌瘤宜行局部切除术，而非眼球摘除术。
两名成年亚裔女性右眼渐进性视力丧失。眼部检查显示眼底有一无色素性穹顶状脉络膜肿块，伴黄色渗出性视网膜脱离。非色素性脉络膜肿瘤的临床鉴别诊断主要包括无色素性黑色素瘤、非典型血管瘤、转移性癌以及罕见的脉络膜后平滑肌瘤。鉴于脉络膜病变更可能是良性肿瘤，我们通过经睫状体平坦部玻璃体切除术行局部切除术，组织病理学检查证实了脉络膜平滑肌瘤的诊断。患者在 6 个月的随访时最佳矫正视力均超过 20/100。
从这两个脉络膜肿瘤病例中，我们可以证明 23-25G 微创玻璃体切除术的局部切除术是一种可行的治疗脉络膜平滑肌瘤的方法。
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