PDF(Pubmed)
Abstract：
UNASSIGNED: The simultaneous occurrence of rhegmatogenous retinal detachment (RRD) and choroidal melanoma is extremely rare, and diagnosis of choroidal melanoma in RRD patients is challenging. As a result, choroidal masses in RRD patients tend to be overlooked, resulting in delayed treatment. The authors report a rare case presenting with simultaneous choroidal melanoma and RRD, and the authors review the related literature.
UNASSIGNED: A 45-year-old Thai man who presented with inferior RRD and choroidal elevation in the left eye was examined using fundoscopy and ultrasonography. The presumptive diagnosis was simultaneous RRD and haemorrhagic choroidal detachment (CD). Vitrectomy and external drainage were attempted but were unsuccessful in draining fluid from the presumed haemorrhagic CD. Although the retina was reattached, the choroidal elevation remained unchanged. After being lost to follow-up, the patient returned later with severe proptosis in the left eye. MRI findings suggested a presumptive diagnosis including choroidal melanoma and choroidal metastasis, which choroidal melanoma was later confirmed through histopathological examination after exenteration.
UNASSIGNED: Important clinical clues were provided for distinguishing between choroidal melanoma and haemorrhagic CD in cases of coexisting RRD.
UNASSIGNED: In the differential diagnosis of RRD with suspicious choroidal elevation, the possibility of the presence of choroidal melanoma should be considered. In particular, in cases where haemorrhagic CD fails to drain during surgery, the possibility of underlying choroidal melanoma should be investigated.
UNASSIGNED: A 45-year-old Thai man who presented with inferior RRD and choroidal elevation in the left eye was examined using fundoscopy and ultrasonography. The presumptive diagnosis was simultaneous RRD and haemorrhagic choroidal detachment (CD). Vitrectomy and external drainage were attempted but were unsuccessful in draining fluid from the presumed haemorrhagic CD. Although the retina was reattached, the choroidal elevation remained unchanged. After being lost to follow-up, the patient returned later with severe proptosis in the left eye. MRI findings suggested a presumptive diagnosis including choroidal melanoma and choroidal metastasis, which choroidal melanoma was later confirmed through histopathological examination after exenteration.
UNASSIGNED: Important clinical clues were provided for distinguishing between choroidal melanoma and haemorrhagic CD in cases of coexisting RRD.
UNASSIGNED: In the differential diagnosis of RRD with suspicious choroidal elevation, the possibility of the presence of choroidal melanoma should be considered. In particular, in cases where haemorrhagic CD fails to drain during surgery, the possibility of underlying choroidal melanoma should be investigated.
摘要：
■同时发生的孔源性视网膜脱离（RRD）和脉络膜黑色素瘤极为罕见，RRD患者脉络膜黑色素瘤的诊断具有挑战性。因此,RRD患者的脉络膜肿块往往被忽视，导致治疗延迟。作者报告了一个罕见的病例同时出现脉络膜黑色素瘤和RRD，作者回顾了相关文献。
■一名45岁的泰国男子，他的左眼表现为下位RRD和脉络膜抬高。推定诊断为同时RRD和出血性脉络膜脱离（CD）。尝试了玻璃体切除术和外部引流，但未成功从假定的出血性CD中排出液体。虽然视网膜重新连接,脉络膜高度保持不变。失去随访后，患者后来返回，左眼严重突出。MRI检查结果提示推测诊断包括脉络膜黑色素瘤和脉络膜转移,后来通过切除后的组织病理学检查证实了脉络膜黑色素瘤。
■在共存的RRD病例中，为区分脉络膜黑色素瘤和出血性CD提供了重要的临床线索。
■在RRD伴可疑脉络膜抬高的鉴别诊断中，应考虑脉络膜黑色素瘤存在的可能性。特别是,在手术期间出血性CD无法引流的情况下，应研究潜在脉络膜黑色素瘤的可能性.
■一名45岁的泰国男子，他的左眼表现为下位RRD和脉络膜抬高。推定诊断为同时RRD和出血性脉络膜脱离（CD）。尝试了玻璃体切除术和外部引流，但未成功从假定的出血性CD中排出液体。虽然视网膜重新连接,脉络膜高度保持不变。失去随访后，患者后来返回，左眼严重突出。MRI检查结果提示推测诊断包括脉络膜黑色素瘤和脉络膜转移,后来通过切除后的组织病理学检查证实了脉络膜黑色素瘤。
■在共存的RRD病例中，为区分脉络膜黑色素瘤和出血性CD提供了重要的临床线索。
■在RRD伴可疑脉络膜抬高的鉴别诊断中，应考虑脉络膜黑色素瘤存在的可能性。特别是,在手术期间出血性CD无法引流的情况下，应研究潜在脉络膜黑色素瘤的可能性.
