Gündüz K, Shields J A, Shields C L, Eagle R C
Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
Ophthalmology. 1998 Apr;105(4):600-5. doi: 10.1016/S0161-6420(98)94011-8.
The authors report their experience with cutaneous melanoma metastatic to the vitreous and elaborate on the features of this entity.
The study design was a retrospective review.
Three patients with four affected eyes from cutaneous melanoma metastatic to the vitreous participated.
All three patients were white men, and their mean age was 58 years. The previously excised cutaneous melanomas were all Clark level IV. The mean interval from diagnosis of the primary cutaneous melanoma to vitreous metastasis was 25 months. Ocular findings included clumps of cells arranged in sheets or linear strands on the vitreous framework. The vitreous cells were nonpigmented in two cases and pigmented in one case. Neovascular glaucoma was found in all three cases. After the diagnosis of vitreous melanoma was made by cytopathologic examination, external beam irradiation (5000 cGy) was given in all patients.
Local tumor control and survival were measured.
At a mean follow-up of 14 months from diagnosis of vitreous melanoma, tumor control was achieved in only one of the four affected eyes. One eye was enucleated because of painful neovascular glaucoma, and the other two eyes had progressive vitreous disease. After a mean follow-up of 14 months (from ocular diagnosis), all three patients had died.
Cutaneous melanoma metastatic to the vitreous can present with nonpigmented or pigmented cells. Neovascular glaucoma frequently is found. External beam radiation therapy often is unsuccessful in local tumor control, and systemic prognosis is poor.
作者报告其对转移性至玻璃体的皮肤黑色素瘤的治疗经验，并详细阐述该疾病实体的特征。
本研究设计为回顾性研究。
三名患有转移性至玻璃体的皮肤黑色素瘤的患者共四只患眼参与了研究。
所有三名患者均为白人男性，平均年龄58岁。先前切除的皮肤黑色素瘤均为克拉克四级。从原发性皮肤黑色素瘤诊断至玻璃体转移的平均间隔时间为25个月。眼部检查发现包括在玻璃体结构上呈片状或线性条索状排列的细胞团块。其中两例玻璃体细胞无色素沉着，一例有色素沉着。所有三例均发现新生血管性青光眼。经细胞病理学检查确诊为玻璃体黑色素瘤后，所有患者均接受了外照射（5000 cGy）。
测量局部肿瘤控制情况和生存率。
从玻璃体黑色素瘤诊断开始平均随访14个月，四只患眼中仅有一只实现了肿瘤控制。一只眼因疼痛性新生血管性青光眼而被摘除，另外两只眼患有进行性玻璃体疾病。平均随访14个月（从眼部诊断开始）后，所有三名患者均已死亡。
转移性至玻璃体的皮肤黑色素瘤可表现为无色素或有色素的细胞。常发现新生血管性青光眼。外照射放疗在局部肿瘤控制方面往往不成功，全身预后较差。
