角结膜恶性黑色素瘤1例(英文)

A case of malignant melanoma of keratoconjunctivitis

原发于角膜的恶性黑色素瘤罕见,我们报道1例。女性,39岁。因左眼发红,发现新生物5mo,于2006-03-28入住我院眼科。眼部检查:右眼视力0.9针孔1.0,左眼视力0.7针孔0.9,光定位和色觉检查正常。左眼颞侧球结膜充血(+),颞侧角膜新生物呈囊状,向角膜中央浸润,角膜上皮层大量色素沉着。初步诊断:左眼角镆新生物(性质待定)。于2006-03-29在局麻下行左眼角膜新生物切除+全板层角膜移植术,术中切除病变组织送病理检查示:左眼角结膜恶性黑色素瘤,免疫组化:HMB45(+),PCK(-)。最后诊断:左眼角结膜恶性黑色素瘤。

Female patient, 39 years. Due to redness of the left eye, a neoplasm had been discovered for 5 months. She was admitted to the ophthahnology department of our hospital on March 28, 2006. Five months ago, the patient＇s left eye presented red. sore, foreign body sensation, and visual deterioration. At our outpatient department, she was diagnosed with cornea neoplasm of the left eye. The neoplasm appeared to be in cystic form, growing quick, and with some pigmentation at the edge. Eye examination： right eyesight 0.9, pin-hole 1.0, left eyesight 0.7, pin-hole 0.9, with normal light projection and trichromatopsia. The conjunctiva of temporal of the left eye engorged （＋）, the neoplasm of temporal infiltrated to the center of cornea. Many pigmentations in cortex of cornea, KP （-）, aqueous humor flare （-）, pupillary margin, high response to luminous reflect, transparent crystalline lens, and no abnormalities in the optical fundus. Primary diagnose： neoplasm in cornea of the left eye （Figure 1）. She was given partial anti-inflammatory therapy alter admitting into the hospital and was given neoplasm excision ＋ transplantation in lamellar cornea of the left eye on partial anaesthesia. The excised tissue was sent to etiopathology for examination.Etiopathology result： Malignant melanoma of keratoconjunctivitis of the left eye, immunohistochemistry： HMB45 （＋） , PCK （-）. Clinical diagnosis confirmed： malignant melanoma of keratoconjunctivitis of the left eye. Partial anti-inflammatory therapy was given to the whole body to avoid infection, promote cornea growth and safeguard against set rejection remedy. When the patient was discharged 2 weeks later, the left eyesight was 0.6, pin-hole 0.7, mixed congestion of the left cornea, cornea patch was in right position and clear, with neither hydrops nor split of operating lines. KP （-） ,AR （-）, pupillary margin, high response to luminous reflect, transparent crystalline lens, and no abnormalities in optical fundus. There was no sign of recidivism when re-examined 3 months after discharge.