出血性脉络膜脱离作为葡萄膜黑色素瘤的首发体征
Hemorrhagic choroidal detachment as the presenting sign of uveal melanoma.
作者信息
Chee Yewlin E, Mudumbai Raghu, Saraf Steven S, Leveque Thellea, Grieco Verena S, Mogensen Monique A, Yoda Rebecca A, Gonzalez-Cuyar Luis F, Stacey Andrew W
机构信息
Department of Ophthalmology, University of Washington, Seattle, WA, USA.
Department of Pathology, Division of Cytology, University of Washington, Seattle, WA, USA.
出版信息
Am J Ophthalmol Case Rep. 2021 Jul 22;23:101173. doi: 10.1016/j.ajoc.2021.101173. eCollection 2021 Sep.
PURPOSE
To describe two cases of medium-sized uveal melanoma presenting with hemorrhagic choroidal detachments.
OBSERVATIONS
The first case is a 39-year-old man who presented with choroidal hemorrhage and angle closure glaucoma. The second case is a 42-year-old man who presented with choroidal hemorrhage and posterior scleritis. Vitrectomy with transvitreous fine needle aspiration biopsy was ultimately required to diagnose malignant uveal melanoma in each case.
CONCLUSIONS AND IMPORTANCE
Intraocular hemorrhage is a rare presenting sign of uveal melanoma. When it does occur, it is typically associated with large tumors. Hemorrhagic choroidal detachments are particularly rare in uveal melanoma, and can limit the diagnostic utility of clinical exam, B-scan ultrasonography, and magnetic resonance imaging. Although it is uncommon, it is important to maintain a high index of suspicion for choroidal melanoma in any patient with unexplained choroidal hemorrhage.
目的
描述两例表现为出血性脉络膜脱离的中等大小葡萄膜黑色素瘤病例。
观察结果
第一例为一名39岁男性，表现为脉络膜出血和闭角型青光眼。第二例为一名42岁男性，表现为脉络膜出血和后巩膜炎。最终，两例均需要通过玻璃体切除术联合经玻璃体细针抽吸活检来诊断恶性葡萄膜黑色素瘤。
结论及重要性
眼内出血是葡萄膜黑色素瘤罕见的表现体征。当出现时，通常与大肿瘤相关。出血性脉络膜脱离在葡萄膜黑色素瘤中尤为罕见，并且会限制临床检查、B超超声检查和磁共振成像的诊断效用。尽管不常见，但对于任何原因不明的脉络膜出血患者，高度怀疑脉络膜黑色素瘤很重要。
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