Völcker H E, Naumann G O
Klin Monbl Augenheilkd. 1976 Mar;168(3):311-7.
Out of 1300 eyes enucleated between 1966-1974, 300 subsequently revealed histologically-proved malignant melanomas of the uvea. In 264 cases the clinical diagnosis was correctly made. In 36 cases the i.o. malignant melanomas were clinically unsuspected. The incorrect clinical diagnoses included: secondary glaucoma (30), retinal detachment (2), iritis (2), and end/panophthalmitis (2). The clinical symptomatology and morphology of the secondary glaucoma caused by the i.o. melanomas did not differ from that due to other, non-neoplastic etiologies. In almost all of the 36 cases the eyes revealed unilateral severe opacity of the media. It is important that one consider an intraocular melanoma in cases of secondary glaucoma, retinal detachment, or intraocular inflammation in which the etiology is uncertain. This is also true in cases of blind, painful eyes in which there is no obvious etiology. Early diagnosis is of vital interest to the patient because this group, in which the malignant melanoma was unsuspected, may be, as suspected in this study, is characterised by extreme aggressivness and invasive capacity. One third of these eyes revealed extension of tumor through the sclera and optic nerve. Also these tumors often revealed more malignant cell types.
在1966年至1974年间摘除的1300只眼中，有300只随后经组织学证实患有葡萄膜恶性黑色素瘤。其中264例临床诊断正确。36例眼内恶性黑色素瘤临床未被怀疑。错误的临床诊断包括：继发性青光眼（30例）、视网膜脱离（2例）、虹膜炎（2例）和眼内炎/全眼球炎（2例）。眼内黑色素瘤引起的继发性青光眼的临床症状和形态与其他非肿瘤性病因引起的继发性青光眼并无差异。在这36例病例中，几乎所有眼睛均表现为单侧严重的介质混浊。重要的是，在继发性青光眼、视网膜脱离或病因不明的眼内炎症病例中，应考虑眼内黑色素瘤。在无明显病因的盲眼、疼痛眼病例中也是如此。早期诊断对患者至关重要，因为在本研究中怀疑，这组未被怀疑患有恶性黑色素瘤的病例具有极高的侵袭性和浸润能力。这些眼中三分之一显示肿瘤通过巩膜和视神经扩展。而且这些肿瘤通常显示出更多的恶性细胞类型。
