皮肤黑色素瘤的玻璃性转移:诊断和管理
Noy Ashkenazy1,2, J William Harbour1,3,2, Sander R Dubovy1,4
1Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida.
Arquivos brasileiros de oftalmologia
|September 19, 2024
概括
皮肤黑色素瘤的玻璃性转移可以模仿脑膜炎. 诊断性玻璃切除术和内化疗为这种罕见的眼部疾病提供了治疗选择.
科学领域:
- 眼科医生 眼科 眼科
- 在瘤学瘤学.
- 医学研究 医学研究
背景情况:
- 皮肤黑色素瘤可以转移到眼睛,特别是玻璃体.
- 玻璃体转移可能呈现为分散的细胞透,可能被误诊为脑膜炎.
- 早期诊断和治疗对于管理眼球黑色素瘤转移至关重要.
研究的目的:
- 详细介绍由皮肤黑色素瘤引起的玻璃性转移患者的临床表现,管理策略和结果.
- 突出这一罕见的眼科疾病的诊断挑战和治疗方法.
主要方法:
- 追溯,单中心病例系列的患者诊断出皮肤黑色素瘤的玻璃性转移 (1997-2020).
- 进行了诊断性帕斯普拉纳玻璃切除术,并通过冷治疗治疗了硬质瘤.
- 在外科手术期间,按指示给出了内内墨法兰注射;视力敏度和眼内压力得到监测.
主要成果:
- 确定了5名患有单边玻璃细胞转移的患者,平均年龄为84岁.
- 临床发现包括玻璃体,前段和视网膜透;四名患者出现了二次绿内障.
- 治疗包括玻璃切除术,内化疗 (梅尔法兰/甲甲酸盐) 和全身疗法;由于黑色素瘤的广泛侵袭,一名患者需要进行核切除.
结论:
- 皮肤黑色素瘤的玻璃性转移可以表现为分散的细胞透,经常被误认为是脑膜炎.
- 部分平面玻璃切除术用于诊断和定期的视内化疗是有价值的治疗方式.
- 及时识别和干预对于管理眼球黑色素瘤转移至关重要.
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