脈絡膜惡性黑色素瘤之病例分析

Analysis of Uveal Malignant Melanoma

欒夢玲(Meng-Ling Luan) ； 彭曄(Yeh Peng)

《中華民國眼科醫學會雜誌》 39卷1期 (2000/03) Pp. 22-27

https://doi.org/10.30048/ACTASOS.200003.0004

摘要

葡萄膜惡性黑色素瘤雖為最常見的眼內惡性腫瘤，但卻好發於白種人，有色人種並不常見，過去雖時有病例報告，但少有連續性的追蹤病例。本文收集本院北院區眼科在過去10年間，因葡萄膜惡性黑色素瘤接受眼球剜除術的19個病例，回溯以病壓及病理切片，分析其基本資料及影響預後的因子。
統計後發現，病患平均年齡47.8歲，男女比例約略相等(9:10)，腫瘤大小多為中等以上（附表一）。病理組識型：紡綞A型1例，紡綞B型1例，類上皮型10例，混合型7例。解剖位置僅1例發生於睫狀體，1例未知，其餘皆向脈絡膜產生。3個病例發生肝轉移，其中2例已逝世。另有一病例於發病同時檢測出直腸癌。一例於外院接受眼球內容物剜除術後，發生眼窩內轉移，未有肺職轉移之病例，，其餘病忠術彼穩定。肝轉移通常是此症致死病因，國外統計其發生時間一般較晚，故術前術後詳細及定期的肝功能及肝臓超音波檢查是很重要的追蹤因子。

並列摘要

The uveal malignant melanoma is the most common intraocular malignant tumor in Caucasian and it rarely occurs in the Orientals. We reported 19 patients who underwent enucleation between 1989 and 1999 for uveal melanoma and had a mean follow-up of 36 months. The average age was 47.8 year old; male equaled to female. Histology showed 1 case of spindle cell type A, 1 of spindle cell B, 10 of epithelioid cell and 7 cases of mixed cell type. Anatomical location included only one case occurred at ciliary body and the rest were developed from choroid. In April 1999, 3 cases had liver metastases and 2 of them expired. There was no pulmonary metastasis found.
One patient was found to have rectal cancer simultaneously, another patient was found to have the intraorbital metastasis after the eviceration done at the other hospital.
The major cause of mortality uncommon, and it usually took place in a later stage according to some foreign studies.
from liver metastasis was not So the regular liver function test and the liver echogram examination pre-and post-operatively plays an important role in the patient's follow-up.

並列關鍵字

Malignant Uveal Melanoma ； Enucleation ； Spindle cell ； Epithelioid cell