背景:脉络膜黑色素瘤是葡萄膜黑色素瘤的亚型之一,是世界范围内相对罕见的眼科恶性肿瘤。然而,它在马来西亚等亚洲国家很稀缺。
目的:我们介绍了8例脉络膜黑色素瘤患者转诊到Serdang医院,一个专门研究眼塑问题的三级中心,从2021年到2022年。
方法:回顾性病例系列,诊断为脉络膜黑色素瘤并转诊至眼形诊所,眼科,Serdang医院,进行了。
结果:共发现8例脉络膜黑色素瘤,年龄中位数为65岁。其中六个是女性,还有两个是男性.有五个马来人,三个是中国人。渐进性视力下降(n=6),明显眼肿块(n=3),视野缺损(n=2)是最常见的症状。平均肿瘤厚度为21.25mm(范围=10-56mm),最大基径10mm~53mm(平均22.5mm)。大多数是大肿瘤(n=7)并且在T3a阶段以上。3例乳酸脱氢酶(LDH)水平升高。组织病理学,其中五个肿瘤是上皮样肿瘤,而其他三种是混合类型。所有患者均接受了摘除术(n=5)和切除术(n=3),其中1例复发。1例患者诊断为脉络膜黑色素瘤,有肝转移。
结论:在马来西亚,脉络膜黑色素瘤的病例越来越多。临床评估仍然是诊断的主要手段。除肿瘤大小外,治疗还应基于多因素预后。LDH水平对于提供廉价但有价值的预测和监测标记可能是必要的。
BACKGROUND: Choroidal melanoma is one of the subtypes of
uveal melanoma and a relatively rare ophthalmic malignancy worldwide. However, it is scarce in Asian countries like Malaysia.
OBJECTIVE: We present eight cases of patients with choroidal melanoma referred to Hospital Serdang, a tertiary centre for oculoplastic issues, from 2021 to 2022.
METHODS: A retrospective case series of patients diagnosed with choroidal melanoma and referred to the Oculoplastic Clinic, Department of Ophthalmology, Hospital Serdang, was undertaken.
RESULTS: A total of eight cases of choroidal melanoma were identified, with a median age of 65 years. Six of them were female, and two were male. There were five of Malay ethnicity, and three were Chinese. Progressive reduced vision (n = 6), noticeable ocular mass (n = 3), and visual field defect (n = 2) were the most common presenting symptoms. The mean tumour thickness was 21.25 mm (range = 10-56 mm), and the largest basal diameter ranged from 10 mm to 53 mm (mean = 22.5 mm). Most were large tumours (n = 7) and above the T3a stage. The level of lactate dehydrogenase (LDH) was elevated in three cases. Histopathologically, five of the tumours were epithelioid, while the other three were mixed types. All patients underwent enucleation (n = 5) and exenteration (n = 3) with one recurrence. One patient had liver metastasis on the diagnosis of choroidal melanoma.
CONCLUSIONS: In Malaysia, there is an increasing number of cases of choroidal melanoma. Clinical evaluation remained the mainstay of diagnosis. Treatment should be based on multifactorial prognostication in addition to tumour size. The LDH level may be necessary for providing inexpensive but valuable prognostication and monitoring markers.