Unilateral Iris Metastasis from Breast Cancer-Case Report

乳癌併發單側虹膜上轉移病例報告

陳清龍(Ching-Long Chen) ； 戴明正(Ming-Cheng Tai) ； 王騰毅(Teng-Yi Wang) ； 陳喬鴻(Chiao-Hong Chen) ； 呂大文(Da-Wen Lu)

《中華民國眼科醫學會雜誌》 45卷1期 (2006/03) Pp. 24-29

https://doi.org/10.30048/ACTASOS.200603.0005

摘要

目的：報告一例因懷疑單側虹膜轉移，經診斷為乳癌合併全身轉移的病例報告。
方法：病例報告。
結果：一位42歲女性，主訴四年前曾因左側乳癌接受手術、放射及化學治療，但一個月前發現右眼紅、畏光，視力變差及有多個肉色結節位於虹膜上。此時懷疑有虹膜轉移，入院後經檢查發現有右肺上葉及腦部轉移，開始接受化學及放射線治療，經十三個月追蹤此病例仍存活並發現位於虹膜上之多個肉色結節變小甚至消失且視力恢復正常。
結論：虹膜轉移可能在腫瘤發生全身轉移時最先被病患察覺，此例曾罹患乳癌並經治療，目前檢查乳房無惡性腫瘤反應。但亦不能因此而忽略乳癌發生全身性轉移的可能。眼科醫師扮演了癌症全身轉移時早期診斷及提早轉介治療的角色，以降低死亡率。

並列摘要

Purpose: To report a 42-year-old woman presented with unilateral iris metastasis and systemic metastasis combined with previous history of breast cancer.
Method: case report.
Result: A 42-year-old woman presented at our outpatient clinic complaining of redness, photophobia and a white spot lesion in her right eye during the previous 1 month. Her visual acuity was 20/25 on right eye and 20/20 on left eye. Slit lamp examination of the right eye showed ciliary injection and multiple yellow flesh iris nodules with angle involvement. A thorough search was conducted under the impression of metastatic iris tumor. The computed tomography (CT) scan of lung revealed a lobulated soft-tissue mass 4cm in size and multiple enhancing nodular lesions over the cerebrum and cerebellum on magnetic resonance imaging study were found as well. The needle biopsy of lung mass was performed and poorly differentiated non-small cell lung cancer or breast cancer with lung metastasis could not be differentiated. After chemotherapy and radiotherapy for breast cancer with systemic metastasis, successful control of lung and brain malignancy had been achieved and relevant regression of iris nodules was noted in the 13 months follow up.
Conclusions: Tumor metastasis to the iris can be the first sign of the systemic metastasis. This case demonstrates the essential role of the ophthalmologist, for early diagnosis and treatment that can help reduce the morbidity and mortality associated with systemic metastases of breast cancer.

並列關鍵字

iris tumor ； breast cancer ； iris metastases