Bret-Dibat C, Rougier M B, Le Rebeller M J, Delaunay M
Service de dermatocancérologie, hôpital Pellegrin, Bordeaux, France.
Bull Cancer. 1996 Dec;83(12):1019-22.
We describe here a case of melanoma-associated retinopathy. In 1993, a 60 year-old man had a cutaneous malignant melanoma surgically removed from the third right toe (thickness 3.15 mm; level IV). One year later he complained suddenly of photopsias, shimmering lights and night blindness of the left eye. Visual acuity and fundus examination were normal. The left visual field showed a tubular aspect. The photopic electroretinogram (ERG) was negative, and the scotopic one was flat. Six weeks later the same symptoms occurred in the right eye. One month later, inguinal lymph nodes were invaded with cancer cells. The association of metastatic melanoma, ocular functional signs and ERG's abnormalities suggested the diagnosis of melanoma-associated retinopathy. This paraneoplastic syndrome is very rare: only seven cases have been described. Antibodies against retinal bipolar cells have shown up in three cases. Treatment is yet to be discovered.
我们在此描述一例黑色素瘤相关性视网膜病变。1993年,一名60岁男性接受手术切除了右足第三趾的皮肤恶性黑色素瘤(厚度3.15mm;IV级)。一年后,他突然抱怨左眼出现闪光感、闪烁的灯光和夜盲。视力和眼底检查正常。左眼视野呈管状。明视视网膜电图(ERG)为阴性,暗视视网膜电图平坦。六周后,右眼出现同样症状。一个月后,腹股沟淋巴结被癌细胞侵犯。转移性黑色素瘤、眼部功能体征和ERG异常的关联提示黑色素瘤相关性视网膜病变的诊断。这种副肿瘤综合征非常罕见:仅报道过7例。3例患者出现了针对视网膜双极细胞的抗体。治疗方法仍有待发现。