Mohan Sukriti, Gange William Steven, Kim Jonathan, Sibug Saber Maria Elena
Department of Ophthalmology, Keck School of Medicine of University of Southern California, Los Angeles, California, USA.
Department of Pathology, Keck School of Medicine of University of Southern California, Los Angeles, California, USA.
Case Rep Ophthalmol. 2022 Mar 17;13(1):196-203. doi: 10.1159/000523804. eCollection 2022 Jan-Apr.
We report the case of a 15-year-old female with a medulloepithelioma who underwent enucleation following plaque brachytherapy. To our knowledge, this is the first report of the histopathological findings of medulloepithelioma following brachytherapy. Histopathology revealed radiation-related changes such as hyalinized vessels, photoreceptor atrophy, degenerative changes of the retina, and preretinal fibrous tissue. Additionally, the retinal nerve fiber layer showed signs of cystoid edema. Subretinal fluid, not commonly associated with medulloepithelioma, was also noted on histology; interestingly, it was seen adjacent to the tumor on B scan prior to brachytherapy. After enucleation, hyaline cartilage was also present on histology, although neuroepithelium was absent. Although we do not have pathological confirmation that neuroepithelium was present prior to brachytherapy, it is possible that brachytherapy preferentially affected neuroepithelium, leading to decrease in tumor size.
我们报告了一例15岁患有髓上皮瘤的女性患者，该患者在敷贴近距离放射治疗后接受了眼球摘除术。据我们所知，这是第一份关于近距离放射治疗后髓上皮瘤组织病理学发现的报告。组织病理学显示了与放疗相关的变化，如血管玻璃样变、光感受器萎缩、视网膜退行性变以及视网膜前纤维组织。此外，视网膜神经纤维层显示出囊样水肿的迹象。组织学检查还发现了视网膜下液，这在髓上皮瘤中并不常见；有趣的是，在近距离放射治疗前的B超检查中，它出现在肿瘤附近。眼球摘除术后，组织学检查还发现了透明软骨，但未发现神经上皮。尽管我们没有病理证实近距离放射治疗前存在神经上皮，但有可能近距离放射治疗优先影响了神经上皮，导致肿瘤大小减小。
