Department of Pathology, All India Institute of Medical Sciences, Bathinda, Punjab, India.
Department of Ophthalmology, Eye Sure Super-Speciality Eye Hospital, Bathinda, Punjab, India.
Indian J Ophthalmol. 2023 Oct;71(10):3281-3289. doi: 10.4103/IJO.IJO_3073_22.
The most common cause of intraocular mass is metastasis from other tumors. Renal malignancies, though rare, have a substantial number of cases with ocular metastasis, few of which were misdiagnosed. Many a times renal malignancies present with ocular manifestations before the primary diagnosis. Here in this article, we comprehensively reviewed 106 cases of ocular metastasis from renal malignancies published till date to the best of our knowledge. The eye is a rare site for distant metastasis because of the lack of a lymphatic system. The most common ocular structures to get involved in distant metastasis are the uveal tract, i.e., choroid, iris, and ciliary body. The most common renal tumor which metastasizes to eyes is renal cell carcinoma (RCC). RCC accounts for less than 2% of all ophthalmic metastases. Out of total 106 cases, the type of renal malignancy was known in 95 cases only, of which 92 had RCC, 1 Wilm's tumor, 1 rhabdoid tumor, and 1 medullary carcinoma. The age ranged widely from 2 weeks old to 81 years old. The male to female ratio was 3.4:1. In total, 67.4% of cases had a previous history of RCC, while the rest 32.6% primarily presented with ophthalmic manifestations first. Treatment modalities included enucleation of the eye, debulking surgery followed by radiotherapy and/or chemotherapy and/or immunotherapy.
眼内肿块最常见的原因是其他肿瘤的转移。肾恶性肿瘤虽然罕见,但有大量眼转移病例,其中少数病例被误诊。许多时候,肾恶性肿瘤在原发诊断前就出现眼部表现。本文综合回顾了迄今为止已发表的 106 例肾恶性肿瘤眼转移病例,就我们所知,这是迄今为止最全面的回顾。由于缺乏淋巴系统,眼睛是远处转移的罕见部位。最常受累的眼部结构是葡萄膜,即脉络膜、虹膜和睫状体。最常转移到眼睛的肾肿瘤是肾细胞癌(RCC)。RCC 占所有眼部转移瘤的不到 2%。在总共 106 例病例中,仅在 95 例中明确了肾恶性肿瘤的类型,其中 92 例为 RCC,1 例为 Wilm 瘤,1 例为横纹肌样瘤,1 例为髓样癌。年龄范围从 2 周大到 81 岁不等。男女比例为 3.4:1。总共 67.4%的病例有 RCC 的既往病史,而其余 32.6%的病例最初表现为眼部表现。治疗方式包括眼球摘除术、减瘤手术联合放疗和/或化疗和/或免疫治疗。