Zheng Jianlong, Chen Weiqi, Huang Dingguo, Wang Yifan, Zheng Dezhi, Zhou Lingling, Brelén Marten E, Huang Zijing
Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, China.
Department of Ophthalmology and Visual Sciences, Chinese University of Hong Kong, Hong Kong, China.
Ann Transl Med. 2021 Mar;9(6):497. doi: 10.21037/atm-21-830.
Due to the variety of clinical presentation, some tumors may be concealed and easily misdiagnosed, leading to delays in management. We report a series of patients who initially presented to an Ophthalmic Clinic with ocular symptoms and were subsequently diagnosed with extraocular tumors.
Patients who presented to the ophthalmic outpatient clinic at the Joint Shantou International Eye Center with ocular symptoms between April 2013 and December 2019 and were subsequently diagnosed with intracranial or systemic tumors were reviewed retrospectively. Clinical data, including ocular symptoms and signs, ophthalmic and systemic imaging examinations, and the results of tumor biopsies were collected and analyzed.
Twenty-three patients were included in this study, of which 16 were female (69.6%) and 7 were male (30.4%). Chief complaints at the first visit included visual loss (n=20), proptosis (n=2), and diplopia (n=1). Ocular examination revealed disc pallor (n=8) and swelling (n=3), choroidal mass with or without chorioretinal detachment (n=5), and proptosis (n=2). Visual field (VF) examination was performed in 11 patients of which hemianopia (n=4) and non-specific field loss (n=7) were noted. Brain CT or MRI, together with histopathological findings from surgical biopsies confirmed the diagnosis of the intracranial tumors in 18 cases, including pituitary adenoma (n=7), meningioma (n=2), oligodendroglioma (n=1), sellar tumor (n=1), suprachiasmatic arteriovenous aneurysm (n=1), orbital glioma (n=1), multiple intracranial tumors (n=1), and sphenoid ossifying fibroma (n=1). Nasopharyngeal carcinoma (NPC) (n=3) was diagnosed with brain MRI and nasal endoscopy. Five patients were confirmed as choroidal metastasis secondary to lung cancer (n=3), hepatoma (n=1), and breast cancer (n=1).
Patients with extraocular tumors may present initially to an ophthalmologist with ocular symptoms. It is important to identify and appropriately manage these patients to avoid unnecessary delays in future treatment.
由于临床表现多样，一些肿瘤可能隐匿且容易误诊，导致治疗延误。我们报告了一系列最初因眼部症状就诊于眼科诊所，随后被诊断为眼外肿瘤的患者。
回顾性分析2013年4月至2019年12月期间在汕头国际眼科中心眼科门诊因眼部症状就诊，随后被诊断为颅内或全身肿瘤的患者。收集并分析临床资料，包括眼部症状和体征、眼科及全身影像学检查以及肿瘤活检结果。
本研究共纳入23例患者，其中女性16例（69.6%），男性7例（30.4%）。首次就诊时的主要症状包括视力下降（n = 20）、眼球突出（n = 2）和复视（n = 1）。眼部检查发现视盘苍白（n = 8）和肿胀（n = 3）、伴有或不伴有脉络膜视网膜脱离的脉络膜肿物（n = 5）以及眼球突出（n = 2）。11例患者进行了视野（VF）检查，其中发现偏盲（n = 4）和非特异性视野缺损（n = 7）。脑部CT或MRI以及手术活检的组织病理学结果确诊了18例颅内肿瘤，包括垂体腺瘤（n = 7）、脑膜瘤（n = 2）、少突胶质细胞瘤（n = 1）、鞍区肿瘤（n = 1）、视交叉上动静脉瘤（n = 1）、眼眶胶质瘤（n = 1）、多发性颅内肿瘤（n = 1）和蝶骨骨化性纤维瘤（n = 1）。通过脑部MRI和鼻内镜诊断为鼻咽癌（NPC）（n = 3）。5例患者确诊为继发于肺癌（n = 3）、肝癌（n = 1）和乳腺癌（n = 1）的脉络膜转移瘤。
眼外肿瘤患者最初可能因眼部症状就诊于眼科医生。识别并妥善管理这些患者以避免未来治疗的不必要延误非常重要。
