分身难题：平滑肌瘤与葡萄膜黑色素瘤
Doppelgänger dilemma: Leiomyoma versus uveal melanoma.
作者信息
Tomar Ankit Singh, Fam Anthony, Finger Paul T, Iacob Codrin E
机构信息
Department of Ocular Tumor and Orbital Disease, The New York Eye Cancer Center, New York, NY, USA.
The New York Eye and Ear Infirmary of Mount Sinai, New York, NY, USA.
出版信息
Am J Ophthalmol Case Rep. 2021 Mar 6;22:101040. doi: 10.1016/j.ajoc.2021.101040. eCollection 2021 Jun.
BACKGROUND
Ciliary body tumors can remain undetected and achieve large dimensions. Pigmented ciliary body tumors include: melanoma, leiomyoma and melanocytoma, however correct diagnosis may require tissue diagnosis with immunohistochemical stains.
CASE PRESENTATION
Two men presented with identical ciliochoroidal tumors. Both had darkly pigmented dome-shaped anterior uveal masses, exudative retinal detachments and transillumination shadowing. Ocular PET-CT imaging revealed that both were metabolically active consistent with a diagnosis of cancer. However, immunohistochemical examination revealed one a leiomyoma and the other melanoma.
CONCLUSION
Uveal leiomyoma can be an indistinguishable doppelgänger to ciliochoroidal melanoma, where the diagnosis can only be established by immunohistopathology.
背景
睫状体肿瘤可能未被发现并长得很大。色素性睫状体肿瘤包括：黑色素瘤、平滑肌瘤和黑素细胞瘤，然而正确诊断可能需要通过免疫组织化学染色进行组织诊断。
病例报告
两名男性患有相同的睫状体脉络膜肿瘤。两人均有色素沉着明显的圆顶状前葡萄膜肿物、渗出性视网膜脱离和透照阴影。眼部PET-CT成像显示两者均有代谢活性，符合癌症诊断。然而，免疫组织化学检查显示其中一例为平滑肌瘤，另一例为黑色素瘤。
结论
葡萄膜平滑肌瘤可能与睫状体脉络膜黑色素瘤难以区分，只有通过免疫组织病理学才能确诊。
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