Haimovici R, Gragoudas E S, Gregor Z, Pesavento R D, Mieler W F, Duker J S
Department of Ophthalmology, Boston University School of Medicine, Massachusetts, USA.
Ophthalmology. 1997 Jul;104(7):1152-8. doi: 10.1016/s0161-6420(97)30169-9.
Choroidal metastases from renal cell carcinoma are uncommon. The authors investigated the clinical characteristics of patients with renal cell carcinoma in whom choroidal metastases developed.
The clinical records of five patients with histopathologically confirmed renal cell carcinoma and choroidal metastases were reviewed retrospectively.
In four patients, choroidal metastases were either the sole initial manifestation of disease or were the initial manifestation of metastatic disease. The interval from nephrectomy to the onset of ocular signs ranged from 6 to 18 years. A reddish-orange appearance of the tumor was present in two patients, but no pathognomonic features distinguishing these tumors from other choroidal metastases were identified.
Ocular metastases may precede the diagnosis of renal cell carcinoma or may follow it by years or decades. This interval between its ocular and systemic presentation may be so prolonged as to obscure the relation between the choroidal metastases and the primary tumor. In patients with amelanotic or reddish choroidal lesions without known metastatic disease, evaluation of the kidney may be warranted as part of a metastatic workup to exclude metastatic renal cell carcinoma.
肾细胞癌的脉络膜转移并不常见。作者研究了发生脉络膜转移的肾细胞癌患者的临床特征。
回顾性分析5例经组织病理学确诊的肾细胞癌合并脉络膜转移患者的临床记录。
4例患者中，脉络膜转移要么是疾病的唯一初始表现，要么是转移性疾病的初始表现。从肾切除到眼部症状出现的间隔时间为6至18年。2例患者肿瘤呈红橙色外观，但未发现将这些肿瘤与其他脉络膜转移瘤区分开来的特征性表现。
眼部转移可能先于肾细胞癌的诊断，也可能在其后数年或数十年出现。其眼部和全身表现之间的间隔时间可能会延长到模糊脉络膜转移瘤与原发肿瘤之间的关系。对于无已知转移性疾病的无色素或红色脉络膜病变患者，作为转移性检查的一部分，对肾脏进行评估可能有助于排除转移性肾细胞癌。
