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15 岁女孩葡萄膜黑色素瘤。病例报告。

UVEAL MELANOMA IN A 15-YEAR-OLD GIRL. CASE REPORT.

出版信息

Cesk Slov Oftalmol. 2021 Spring;77(2):94-100. doi: 10.31348/2021/13.

Abstract

Uveal melanoma is the most common intraocular tumour in adults, it is a form of cancer that affects mostly older adults, as the average age at detection of this tumour is 60 years, but it can occur in any age group with no significant gender difference. However, uveal melanoma is very rare in children compared to the adult population, accounting for 1 % of all cases. In pediatric patients, malignant uveal melanoma is more frequently manifested during puberty, leading to speculation of an association between uveal melanoma and growth hormone levels. Prognostic factors for uveal melanoma include tumour histology, chromosomal abnormalities, tumour size, extrascleral spread and tumour location. Risk factors for uveal melanoma include melanocytosis, neurofibromatosis type 1 and dysplastic naevus syndrome. Some studies point to a significantly lower risk of developing metastases in younger patients, but the prognosis of uveal melanoma in children is not yet fully known. Clinical signs and treatment options for malignant uveal melanoma in children are still under discussion. Differential diagnosis of uveal lesions in children can sometimes be very difficult, as evidenced by following case report in which authors describe a case of choroidal melanoma in a 15-year-old girl.

摘要

葡萄膜黑色素瘤是成年人中最常见的眼内肿瘤,是一种主要影响老年人的癌症,因为这种肿瘤的平均检出年龄为 60 岁,但它可以发生在任何年龄组,且无明显的性别差异。然而,与成年人相比,儿童中葡萄膜黑色素瘤非常罕见,占所有病例的 1%。在儿科患者中,恶性葡萄膜黑色素瘤更常发生在青春期,这导致人们推测葡萄膜黑色素瘤与生长激素水平之间存在关联。葡萄膜黑色素瘤的预后因素包括肿瘤组织学、染色体异常、肿瘤大小、眼外扩散和肿瘤位置。葡萄膜黑色素瘤的危险因素包括黑色素沉着、神经纤维瘤病 1 型和发育不良痣综合征。一些研究表明,年轻患者发生转移的风险显著降低,但儿童葡萄膜黑色素瘤的预后尚不完全清楚。儿童恶性葡萄膜黑色素瘤的临床特征和治疗选择仍在讨论中。儿童葡萄膜病变的鉴别诊断有时非常困难,以下病例报告就证明了这一点,作者描述了一例 15 岁女孩脉络膜黑色素瘤。

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