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題名 | Diffuse Iris Malignant Melanoma with Secondary Glaucoma--A Case Report=瀰散性虹膜惡性黑色素細胞瘤併次發性青光眼之病例報告 |
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作者 | 蘇姵元; 黃振宇; 蕭吉晃; | 書刊名 | 中華民國眼科醫學會雜誌 |
卷期 | 49:2 2010.06[民99.06] |
頁次 | 頁233-240 |
分類號 | 416.74 |
關鍵詞 | 瀰散性虹膜惡性黑色素細胞瘤; 青光眼; Iris melanoma; Hyperchromic heterochromia iridis; Secondary glaucoma; |
語文 | 英文(English) |
中文摘要 | 目的:報告瀰散性虹膜惡性黑色素細胞瘤併次發性青光眼之病例。方法:病例報告。結果:一位46歲女性主訴右眼紅併視力模糊,因右眼眼壓高無法控制轉診至本院。檢查發現病患右眼虹膜有一色素性結節腫瘤及彌散性的虹膜黑色素斑塊,同時合併次發性青光眼。經藥物治療後眼壓控制良好,由於發現腫瘤有蔓延趨勢,於是進行眼球摘除手術治療,病例切片結果證實為惡性黑色素細胞瘤。追蹤至術後22個月為止病患並無腫瘤轉移現象。結論:瀰散性虹膜惡性黑色素細胞瘤是一罕見卻可能致命的疾病,診斷上須高度懷疑雙眼虹膜色素不均併單眼青光眼表現之病患。治療上常需摘除眼球,並注意迫蹤腫瘤轉移。 |
英文摘要 | Purpose: To report a case of diffuse iris melanoma. Methods: Case report. Results: A 46-year-old female had suffered from blurred vision and redness of the right eye for four months and was referred to our clinic due to uncontrollable intraocular pressure. Ophthalmic examination of the right eye revealed an iris nodule with scattered hyperpigmented flat patches all over the iris surface and secondary glaucoma. Gonioscopy and ultrasound biomicroscopy showed a pigmented mass lesion arising from iris stroma with wide spreading to the angle structure. MRI showed a tiny spot at inferior margin of right lens, which had high signal on fat-saturated T1W and low signal on T2W image. The patient received medical treatment initially for glaucoma and then enucleation later due to documented tumor growth. Histopathology examination showed predominant epithelioid type malignant melanoma. The patient remained free from systemic metastasis during the 22 months follow-up period. Conclusion: Diffuse iris melanoma is rare but a potentially lethal condition. It should be suspected in patients presenting with hyperchromic heterochromia and ipsilateral secondary glaucoma. Enucleation is usually required for treatment and followed by regular systemic check up for distant metastasis. |
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