PDF(Pubmed)
Abstract：
Aim: To report an exceptionally rare case of malignant choroidal melanoma with vitreous seeding, supported by histopathological and field emission scanning electron microscopic (FESEM) studies. Case report: A 58-year-old male with painless diminution of vision in his left eye for past 1 month was found to have a brown retrolental mass lesion on slit lamp examination in the left eye. Detailed fundus examination revealed choroidal melanoma in the left eye with pigmented seeds extending into the vitreous cavity and associated exudative retinal detachment. Ocular imaging was consistent with the diagnosis. Results: The eyeball was enucleated and the tumor was considered as stage IIB (AJCC 8th edition classification). Metastatic workup of the patient was negative. One half of the eyeball was subjected to field emission scanning electron microscopy to further study the nature and appearance of vitreous seeds. Discussion: Vitreous seeding in choroidal melanoma has been reported only in a handful of cases in literature. Histopathological confirmation of vitreous seeds was done in our case and morphological detailing was performed using FESEM study. Conclusions: Treatment naïve choroidal melanoma can very rarely have vitreous seeds. Early enucleation in such cases carries a favorable prognosis.
摘要：
目的：报告一例罕见的恶性脉络膜黑色素瘤伴玻璃体种植，由组织病理学和场发射扫描电子显微镜（FESEM）研究支持。病例报告：一名58岁的男性，在过去的1个月中左眼无痛视力下降，在左眼的裂隙灯检查中发现了棕色的后牙肿块病变。详细的眼底检查显示左眼脉络膜黑色素瘤，色素沉着的种子延伸到玻璃体腔，并伴有渗出性视网膜脱离。眼部影像学与诊断一致。结果：眼球摘除，肿瘤被认为是IIB期（AJCC第8版分类）。患者的转移检查为阴性。对眼球的一半进行了场发射扫描电子显微镜检查，以进一步研究玻璃体种子的性质和外观。讨论：脉络膜黑色素瘤中的玻璃体接种仅在少数文献中报道。在我们的病例中进行了玻璃体种子的组织病理学确认，并使用FESEM研究进行了形态学详细说明。结论：治疗初期脉络膜黑色素瘤很少有玻璃体种子。在这种情况下的早期摘除具有良好的预后。
