Department of Ophthalmic plastic & reconstructive surgery and facial aesthetics, Sri Sankaradeva Nethralaya, Guwahati, Assam, India.
Department of Vitreo-Retina, Sri Sankaradeva Nethralaya, Guwahati, Assam, India.
Rom J Ophthalmol. 2023 Apr-Jun;67(2):180-184. doi: 10.22336/rjo.2023.31.
To report an exceptionally rare case of malignant choroidal melanoma with vitreous seeding, supported by histopathological and field emission scanning electron microscopic (FESEM) studies. A 58-year-old male with painless diminution of vision in his left eye for past 1 month was found to have a brown retrolental mass lesion on slit lamp examination in the left eye. Detailed fundus examination revealed choroidal melanoma in the left eye with pigmented seeds extending into the vitreous cavity and associated exudative retinal detachment. Ocular imaging was consistent with the diagnosis. The eyeball was enucleated and the tumor was considered as stage IIB (AJCC 8th edition classification). Metastatic workup of the patient was negative. One half of the eyeball was subjected to field emission scanning electron microscopy to further study the nature and appearance of vitreous seeds. Vitreous seeding in choroidal melanoma has been reported only in a handful of cases in literature. Histopathological confirmation of vitreous seeds was done in our case and morphological detailing was performed using FESEM study. Treatment naïve choroidal melanoma can very rarely have vitreous seeds. Early enucleation in such cases carries a favorable prognosis.
报告一例罕见的伴有玻璃体内播种的恶性脉络膜黑色素瘤病例，该病例得到了组织病理学和场发射扫描电子显微镜（FESEM）研究的支持。一名 58 岁男性左眼无痛性视力减退 1 个月，左眼裂隙灯检查发现视网膜后有棕色肿块病变。详细眼底检查发现左眼脉络膜黑色素瘤，色素性种子延伸至玻璃体腔，并伴有渗出性视网膜脱离。眼部成像符合诊断。眼球被剜除，肿瘤被认为是 IIB 期（AJCC 第 8 版分类）。对患者进行了转移性检查，结果为阴性。一半眼球被用于场发射扫描电子显微镜进一步研究玻璃体内种子的性质和外观。脉络膜黑色素瘤中的玻璃体内播种仅在少数文献中报道过。在我们的病例中进行了玻璃体内种子的组织病理学确认，并使用 FESEM 研究进行了形态学详细描述。未经治疗的脉络膜黑色素瘤很少有玻璃体内种子。在这种情况下，早期眼球摘除预后良好。
