Mezer E, Gdal-On M, Miller B
Department of Ophthalmology, Rambam Medical Center, Haifa, Israel.
Eur J Ophthalmol. 1997 Jul-Sep;7(3):301-4. doi: 10.1177/112067219700700318.
Renal cell carcinoma (RCC) is the most common malignancy involving the kidney. Only rarely does it metastasize to the eye and orbit, sometimes mimicking other lesions. A 70-year-old woman was referred from neurology because of a right orbital lesion, six months after the start of a neurological investigation because of amaurosis fugax. Six months earlier she had complained of transient visual disturbances in her right eye. After excluding cardiovascular abnormalities and coagulopathies as the source of her complaints, she was diagnosed as having a right senile ptosis. A computed tomography scan, done to complete the workout, detected a right orbital mass. The patient was referred to the oculoplastic unit. A biopsy and then a lateral orbitotomy were performed. Histopathological examination proved it to be a metastatic renal cell carcinoma, seven years after the primary tumor had been diagnosed and treated by nephrectomy. The characteristics of metastatic renal cell carcinoma are discussed, in view of the rarity of metastasis to the eye and, in particular, to the orbit, and its tendency to masquerade as other lesions or symptoms. In this case it presented as amaurosis fugax before other signs appeared.
肾细胞癌（RCC）是最常见的累及肾脏的恶性肿瘤。它极少转移至眼和眼眶，有时会与其他病变相似。一名70岁女性因右侧眼眶病变从神经科转诊而来，该病变是在因一过性黑矇开始进行神经学检查6个月后发现的。6个月前她曾抱怨右眼出现短暂视力障碍。在排除心血管异常和凝血障碍作为其症状根源后，她被诊断为右侧老年性上睑下垂。为完善检查进行的计算机断层扫描发现右侧眼眶有一肿物。该患者被转诊至眼整形科。进行了活检，随后做了外侧眶切开术。组织病理学检查证实为转移性肾细胞癌，此时距离原发性肿瘤经肾切除术诊断并治疗已过去7年。鉴于肾细胞癌转移至眼尤其是眼眶非常罕见，且有伪装成其他病变或症状的倾向，本文讨论了转移性肾细胞癌的特点。在该病例中，它在出现其他体征之前表现为一过性黑矇。
