Gündüz K, Shields J A, Shields C L, Eagle R C
Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pa., USA.
Arch Ophthalmol. 1998 Aug;116(8):1112-4. doi: 10.1001/archopht.116.8.1112.
A 14-year-old male adolescent with ocular melanocytosis and secondary glaucoma in the left eye had a 2-year history of a progressively enlarging fundus lesion. Ocular examination revealed diffuse hyperpigmentation of the episclera and a smooth velvety thickening and hyperpigmentation of the left iris. Ophthalmoscopy disclosed diffuse choroidal pigmentation and a pigmented mass that occupied the macular area and surrounded the optic nerve. Ultrasonography showed an acoustically hollow lesion with scleral bowing and choroidal excavation. Based on clinical and ultrasonographic findings, the diagnosis was choroidal melanoma in a young patient with ocular melanocytosis. The eye was enucleated. Histopathologic examination revealed ocular melanocytosis with diffuse uveal melanocytosis and amelanotic malignant melanoma of the choroid. The choroidal melanoma apparently arose from a preexisting choroidal nevus. Even young patients with ocular melanocytosis should have regular follow-up examinations for early detection of uveal melanoma.
一名14岁男性青少年，左眼患有眼部黑素沉着症和继发性青光眼，眼底病变逐渐增大已有2年病史。眼部检查发现巩膜外层弥漫性色素沉着，左眼虹膜光滑如天鹅绒般增厚且色素沉着。检眼镜检查发现脉络膜弥漫性色素沉着以及一个色素性肿块，该肿块占据黄斑区并环绕视神经。超声检查显示一个无回声病变，伴有巩膜弯曲和脉络膜凹陷。根据临床和超声检查结果，诊断为一名患有眼部黑素沉着症的年轻患者的脉络膜黑色素瘤。该眼被摘除。组织病理学检查显示眼部黑素沉着症伴弥漫性葡萄膜黑素细胞增多以及脉络膜无色素性恶性黑色素瘤。脉络膜黑色素瘤显然起源于先前存在的脉络膜痣。即使是患有眼部黑素沉着症的年轻患者也应定期进行随访检查，以便早期发现葡萄膜黑色素瘤。
