Wertheimer R, Maier M, Hofmann H M, Stanowsky A, Weiss M
Augenklinik, Technische Universität München, Klinikum rechts der Isar.
Ophthalmologe. 1993 Oct;90(5):522-7.
Carcinoid tumors are slowly and locally invasive growing neoplasms. Their main localization is in the ileum or in organs derived from the embryonic foregut, i.e. bronchus, stomach, pancreas and thyroid. The low rate of metastatic manifestation of about 10% indicates their potential malignancy. The endocrine effects vary. We describe the case of a 30-year-old female patient, who had had a carcinoid tumor of the bronchus with infiltration of a hilar lymph node, which had been resected two years previously. The postoperative course was marked by an increased level of urine 5-hydroxyindolacetic acid (5-HIAA). Finally, the patient complained a 4-month history of recurrent episodes of refractory conjunctival hyperemia, visual loss and visual field defects in both eyes. Examination revealed bilateral multiple choroidal masses associated with retinal detachment. As various authors have reported, carcinoid tumor metastases to the eye are extremely rare. Diagnostic approaches and therapeutic considerations are described. Ultrasonic examination of the choroidal lesion, applying standardized A-scan echography at tissue sensitivity, showed solid tissue masses and bilateral circumscribed exudative retinal detachment. The tumor was characterized by medium to high reflectivity and slight sound attenuation. The internal structure showed less irregularity than is usually seen in metastases.
类癌肿瘤是生长缓慢且具有局部侵袭性的肿瘤。其主要定位在回肠或源自胚胎前肠的器官，即支气管、胃、胰腺和甲状腺。约10%的低转移发生率表明其具有潜在的恶性。内分泌效应各不相同。我们描述了一名30岁女性患者的病例，她曾患有支气管类癌肿瘤并伴有肺门淋巴结浸润，该肿瘤已于两年前切除。术后病程以尿5-羟吲哚乙酸（5-HIAA）水平升高为特征。最后，患者主诉双眼有4个月反复发作的难治性结膜充血、视力丧失和视野缺损病史。检查发现双侧多个脉络膜肿块伴有视网膜脱离。正如各位作者所报道的，类癌肿瘤转移至眼部极为罕见。本文描述了诊断方法和治疗考量。对脉络膜病变进行超声检查，采用组织敏感性标准化A超扫描，显示为实性组织肿块和双侧局限性渗出性视网膜脱离。肿瘤的特征是中到高反射率和轻微的声衰减。其内部结构的不规则程度低于通常在转移瘤中所见。
