Turut P, Madelain J
Service d'Ophtalmologie C.H.R. Centre Saint-Victor, Amiens.
J Fr Ophtalmol. 1988;11(1):17-23.
We report 3 cases of macular or perimacular adenomas of the R.P.E. These tumors are small, deeply pigmented and arise abruptly like a pyramid from a flat base over laying retina. There is no intra-tumoral vascularisation during angiography. They typically grow very slowly or not. Metastasis from them has never been described like a certainty with histological evidence. Clinical course, histological aspects are very similar to a carcinoma of R.P.E. They have a tubular or cord-like arrangement of proliferated R.P.E. cells. The main problem is to differentiate these tumors from first malignant melanomas and other uveal pigmented tumors and second others nonneoplastic proliferations of R.P.E.: essentially unifocal congenital hypertrophy and reactive hyperplasia. Management of these tumors depends of clinical characteristics and often behavior of the tumor with periodical photographic or ultrasonic supervision to detect evidence of growth which could lead to enucleation to obtain histologic evidence for fear of uveal malignant tumor.
我们报告了3例视网膜色素上皮(R.P.E.)黄斑或黄斑周围腺瘤病例。这些肿瘤较小,色素沉着深,从覆盖视网膜的扁平基底突然呈金字塔状隆起。血管造影显示肿瘤内无血管形成。它们通常生长非常缓慢或不生长。从未有过经组织学证实的明确转移报道。其临床过程、组织学特征与视网膜色素上皮癌非常相似。增殖的视网膜色素上皮细胞呈管状或索状排列。主要问题是将这些肿瘤与原发性恶性黑色素瘤和其他葡萄膜色素性肿瘤以及继发性视网膜色素上皮的其他非肿瘤性增殖区分开来:主要是单灶性先天性肥大和反应性增生。这些肿瘤的治疗取决于临床特征以及肿瘤的行为,通常需要定期进行摄影或超声监测,以发现可能导致眼球摘除的生长迹象,因为担心葡萄膜恶性肿瘤,需要获取组织学证据。