Department of Respiratory Medicine, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
Department of Ophthalmology, University of Occupational and Environmental Health, Japan, Kitakyushu, Japan.
Thorac Cancer. 2022 Jun;13(11):1739-1743. doi: 10.1111/1759-7714.14440. Epub 2022 Apr 22.
A 63-year-old Japanese man with amyopathic dermatomyositis treated with immunosuppressants became aware of distortion of his left visual field, and a metastatic choroidal tumor was suspected. His chest computed tomography (CT) showed a pulmonary nodule in the right upper lobe and mediastinal lymphadenopathy, and he was diagnosed with advanced lung adenocarcinoma with choroidal metastasis. Malignancies associated with dermatomyositis (DM) are often rapidly progressive and, in choroidal metastasis associated with lung cancer, a choroidal lesion is often diagnosed prior to lung cancer; therefore, CT performed at the time of diagnosis of choroidal metastasis may show lung cancer lesions. When ocular symptoms are observed in DM patients, metastatic malignancies should be suspected, and systemic examinations, such as positron emission tomography (PET)-CT, should also be performed.
一位 63 岁的日本男性,患有免疫抑制治疗的无肌病性皮肌炎,出现左侧视野扭曲,疑似转移性脉络膜肿瘤。他的胸部计算机断层扫描(CT)显示右上肺叶肺结节和纵隔淋巴结病,被诊断为晚期肺腺癌伴脉络膜转移。与皮肌炎(DM)相关的恶性肿瘤通常进展迅速,在与肺癌相关的脉络膜转移中,脉络膜病变通常在肺癌之前被诊断;因此,在诊断脉络膜转移时进行的 CT 可能会显示肺癌病变。当 DM 患者出现眼部症状时,应怀疑转移性恶性肿瘤,并进行全身检查,如正电子发射断层扫描(PET)-CT。