Michelson J B, Felberg N T, Shields J A, Folberg R
Cancer. 1978 Jun;41(6):2301-4. doi: 10.1002/1097-0142(197806)41:6<2301::aid-cncr2820410631>3.0.co;2-8.
A 58-year-old white male with a history of bronchogenic carcinoma presented with a total retinal detachment overlying a choroidal metastasis. His main tumor burden had been extirpated by pneumonectomy followed by radiation therapy four months prior to admission. With the development of a painful, glaucomatous eye, unresponsive to conventional therapy, enucleation was performed. Histologic examination of the enucleated globe revealed a metastatic tumor to the choroid, consistent with primary bronchogenic carcinoma. Aqueous humor and plasma examination revealed elevated ratios (Aqueous humor:Plasma) of lactate dehydrogenase (LDH) and phosphoglucose isomerase (PGI). Furthermore, subretinal fluid examination demonstrated concentrations of LDH and PGI higher than aqueous humor. While the level of carcinoembryonic antigen (CEA) in the plasma was normal (less than 2.5 ng/ml) following pneumonectomy, it was 121 ng/ml in the subretinal fluid. This would suggest that a choroidal lesion alone, in the absence of a clinically detectable primary tumor, is insufficient to elevate the plasma CEA.
一名58岁有支气管源性癌病史的白人男性，出现了覆盖脉络膜转移灶的视网膜全脱离。其主要肿瘤负荷在入院前四个月已通过肺切除术切除，随后进行了放射治疗。随着疼痛性青光眼性眼的发展，对传统治疗无反应，遂行眼球摘除术。摘除眼球的组织学检查显示脉络膜有转移性肿瘤，与原发性支气管源性癌相符。房水和血浆检查显示乳酸脱氢酶（LDH）和磷酸葡萄糖异构酶（PGI）的比率（房水：血浆）升高。此外，视网膜下液检查显示LDH和PGI的浓度高于房水。虽然肺切除术后血浆中癌胚抗原（CEA）水平正常（低于2.5 ng/ml），但视网膜下液中CEA水平为121 ng/ml。这表明在没有临床可检测到的原发性肿瘤的情况下，仅脉络膜病变不足以使血浆CEA升高。
