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題 名 | Bilateral Diffuse Uveal Melanocytic Proliferation in a Woman with Uterine Leiomyoma: Case Report=子宮肌瘤病患之雙側廣泛性葡萄膜黑色素細胞增生:病例報告 |
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作 者 | 陳以晟; 李佳芸; 郭雅慧; 何昭德; 陳珊霓; | 書刊名 | 長庚醫學 |
卷 期 | 24:4 2001.04[民90.04] |
頁 次 | 頁274-279 |
分類號 | 417.281 |
關鍵詞 | 雙側廣泛性葡萄膜黑色素細胞增生; 癌關聯症候群; 子宮肌瘤; Bilateral diffuse uveal melanocytic proliferation; Paraneoplastic syndrome; Uterine leiomyoma; |
語 文 | 英文(English) |
英文摘要 | Bilateral diffuse uveal melanocytic proliferation (BDUMP) associated with systemic carcinoma is a rare paraneoplastic syndrome. It was reported to be associated with primary carcinomas of the lung, ovary, colon, gall bladder, esophagus, pancreas, uterus, and cervix. We report a case of BDUMP that occurred in a woman with cervical leiomyoma. The 79-year-old woman experienced bilateral progressive visual loss to hand motion within 2 weeks. Fundus examination showed bilateral exudative retinal detachment and multiple oval red patches. Echographic study showed diffuse thickening of the uveal tracts. Fluorescein angiography showed multiple patches of window defect without late leakage, which was correlated with the oval red patches. After screening for tumor markers and meticulous examinations, an elevated serum level of CA-125 was noted. The only neoplasm found in this patient was a cervical leiomyoma, which has never been reported to be associated with BDUMP. One month after the onset of symptoms, accidental head injury due to poor vision led to right parietal intracerebral hemorrhage and left hemiplegia. Prompt diagnosis of this paraneoplastic syndrome is important to discover the underlying malignancy in patients with no history of cancer. For those cases without malignant neoplasm, attention should be directed to the disability caused by the severe visual loss, which led to accidental head injury and intracerebral hemorrhage in this case. (Chang Gung Med J 2001;24:274-9) |
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