Sia David I T, Agi Jorge, Grewal Parampal, Russell Laurie, Weis Ezekiel
Department of Ophthalmology and Visual Sciences, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Department of Surgery, Faculty of Medicine and Dentistry, University of Calgary, Calgary, Alberta, Canada.
Ocul Oncol Pathol. 2020 Oct;6(5):344-352. doi: 10.1159/000507399. Epub 2020 Jun 2.
Melanocytoma or hyperpigmented magnocellular nevus is a variant of melanocytic nevus that is most commonly seen in the optic nerve, but has also been reported to occur in the iris, ciliary body, choroid, sclera, and conjunctiva. We present two cases of giant uveal melanocytoma with histopathology. The first case occurred in a 10-year-old girl who presented with decreased vision in the right eye and a mushroom-shaped pigmented choroidal lesion measuring 15.5 mm in apical height. The lesion was abutting the lens but not causing a cataract. This was diagnosed as a choroidal melanocytoma on open scleral window biopsy. The second case was in a 68-year-old lady, referred for a left nasal pigmented choroidal lesion measuring 8 mm in apical height and having a mushroom configuration. The lesion grew to 8.6 mm in height and was complicated by a vitreous hemorrhage and rhegmatogenous retinal detachment and was treated with iodine-125 plaque brachytherapy. Subsequently, the treated eye became a painful phthisical eye and was enucleated. Histopathology confirmed melanocytoma with extrascleral extension but without malignant transformation. Features of melanocytoma and other very large cases reported in the literature are discussed.
黑素细胞瘤或色素性大细胞痣是黑素细胞痣的一种变体，最常见于视神经，但也有报道称其发生于虹膜、睫状体、脉络膜、巩膜和结膜。我们报告两例巨大葡萄膜黑素细胞瘤的组织病理学情况。第一例发生在一名10岁女孩身上，她表现为右眼视力下降，有一个蘑菇状色素性脉络膜病变，顶端高度为15.5毫米。病变紧邻晶状体，但未导致白内障。经开放性巩膜窗活检诊断为脉络膜黑素细胞瘤。第二例是一位68岁女性，因左眼鼻侧有一个顶端高度为8毫米、呈蘑菇状的色素性脉络膜病变前来就诊。病变高度增长至8.6毫米，并伴有玻璃体积血和孔源性视网膜脱离，接受了碘-125敷贴近距离放射治疗。随后，治疗后的眼睛变成了疼痛的眼球痨，最终被摘除。组织病理学证实为黑素细胞瘤，有巩膜外扩展，但无恶性转化。文中还讨论了黑素细胞瘤的特征以及文献中报道的其他非常大的病例。
