Fezza J, Chaudhry I A, Kwon Y H, Grannum E E, Sinard J, Wolfley D E
Department of Ophthalmology, Yale University, USA.
Ophthalmic Plast Reconstr Surg. 1998 Jul;14(4):286-9. doi: 10.1097/00002341-199807000-00012.
Most choroidal melanomas are diagnosed when the tumor is still relatively small and confined to the globe. Rarely, these tumors can escape detection and extend through the sclera. They can reach a large size and create significant orbital inflammation. The authors describe a 71-year-old man with orbital cellulitis secondary to a necrotic choroidal melanoma that invaded the orbit. This tumor had minimal intraocular involvement with a large extrascleral component. On histopathologic analysis, the lesion was best classified as a spindle B melanoma with epithelioid areas (mixed melanoma). The patient was treated with an enucleation and postoperative radiation. This report demonstrates that malignancies in the orbit can present as acute infections. Early suspicion, diagnosis, and treatment of these lesions offer the best chance for survival.
大多数脉络膜黑色素瘤在肿瘤仍相对较小且局限于眼球内时被诊断出来。这些肿瘤很少会逃过检测并穿透巩膜。它们可能长得很大并引发严重的眼眶炎症。作者描述了一名71岁男性，因坏死性脉络膜黑色素瘤侵犯眼眶继发眼眶蜂窝织炎。该肿瘤眼内受累极少，巩膜外成分较大。组织病理学分析显示，该病变最适合归类为具有上皮样区域的梭形B黑色素瘤（混合性黑色素瘤）。患者接受了眼球摘除术及术后放疗。本报告表明，眼眶恶性肿瘤可表现为急性感染。对这些病变的早期怀疑、诊断和治疗为生存提供了最佳机会。
