脈絡膜惡性黑色素細胞瘤－病例報告

Choroidal Melanoma-A Case Report

許慶璋(Ching-Jang Sheu) ； 郭錦彰(Giien-Chang Guo) ； 陳俊良(Jiunn-Liang Chen)

《中華民國眼科醫學會雜誌》 34卷2期 (1995/06) Pp. 271-276

https://doi.org/10.30048/ACTASOS.199506.0019

摘要

葡萄膜惡性黑色素細胞瘤是很少見於深膚色人種，但它是白人中成人最常見的原位性且具致命性的眼球內惡性腫瘤。眼球摘除是傳統療法。此腫瘤擴散轉移後死亡率很高。眼球摘除後之擴散轉移和此腫瘤大小，位置，細胞分類和有無鞏膜外侵犯有直接的關係。
本篇報告一位56歲男性，在門診時，無意中發現患者右眼有一巨大脈絡膜腫瘤合併滲出性視網膜剝離並侵犯到視神經乳頭。從間接眼底鏡及超音波和眼眶電腦斷層掃描中確定腫瘤診斷和大小及位置。病患接受右眼摘除術，病理報告為脈絡膜惡性黑色素細胞瘤並與局部轉移現象。且術前並無它處轉移跡象。
本文中將對葡萄膜惡性黑色素瘤的診斷，治療及預後作回顧性的討論。

並列摘要

Uveal melanoma is rare in nonwhite race but is the most common primary intraocular malignancy and is the main primary intraocular disease that can be fatal in adults. Metastasis from vueal melanoma usually occurs within the first few years after enucleation. Patients at highest risk of metastasis after enucleation are those with large tumors, more anterior tumors, tumor with more epitheloid cells and those with extrascleral extension of the tumor.
A case of choroidal melanoma in an aged male who accepted enucleation was presented. The ocular sonography and orbital CT scan confirmed the tumor location and tumor size. The pathological examination revealed spindle-shape type melanoma. Whole body bone scan, chest X-ray and whole abdomen sonography revealed no signs of distal metastasis before enucleation. The clinical manifestations of this uncommon case in Taiwan were described and the diagnosis and prognosis were discussed.

並列關鍵字

choroidal melanoma ； exudative retinal detachment ； enucleation