Wagley Sushant, Tran Tu M, Mallory Paul W, Lee Michael S, Armbrust Karen R, Trautman Bruce, Montezuma Sandra R
Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota, USA.
VA Health Care System, Minneapolis, Minnesota, USA.
Ocul Oncol Pathol. 2021 Mar;7(1):31-35. doi: 10.1159/000511189. Epub 2020 Dec 18.
An 84-year-old female presented with bilateral scotomas and progressive nyctalopia over 1 year. Best-corrected visual acuity was 20/50 in both eyes with reduced color vision. Goldmann visual field showed bilateral cecocentral scotomas and generalized constriction of the visual fields. This led to an electroretinogram showing an electronegative pattern consistent with autoimmune retinopathies. Infectious workup was negative. Anti-retinal antibodies were positive, leading to a presumed diagnosis of cancer-associated retinopathy (CAR). Imaging showed a previously unknown left renal lower pole mass, and she underwent a radical nephrectomy. Biopsy showed nuclear grade-3 clear cell renal carcinoma staged T1. The patient was treated with oral prednisone with no ocular improvement. We report on a rare case of clear cell renal carcinoma causing CAR. CAR is an important paraneoplastic syndrome to diagnose since the majority of ocular cases precede other manifestations of malignancy. Therefore, a timely diagnosis of CAR can be lifesaving or at least life-extending.
一名84岁女性出现双侧暗点和进行性夜盲1年。双眼最佳矫正视力为20/50，色觉减退。Goldmann视野检查显示双侧中心暗点和视野普遍缩小。这导致视网膜电图显示与自身免疫性视网膜病变一致的阴性模式。感染检查结果为阴性。抗视网膜抗体呈阳性，推测诊断为癌症相关性视网膜病变（CAR）。影像学检查显示左肾下极有一个此前未知的肿块，她接受了根治性肾切除术。活检显示为核分级3级的透明细胞肾细胞癌，分期为T1。患者接受口服泼尼松治疗，眼部情况无改善。我们报告一例罕见的透明细胞肾细胞癌导致CAR的病例。CAR是一种重要的副肿瘤综合征，需要诊断，因为大多数眼部病例先于恶性肿瘤的其他表现出现。因此，及时诊断CAR可以挽救生命或至少延长生命。
