胃癌眼部转移临床特征分析

Clinical Characteristics of Ocular Metastasis of Gastric Cancer

背景:胃癌常见远处转移部位为肝脏、肺、骨等,眼部转移相对罕见。目的:分析胃癌眼部转移的临床特征,提高对这一罕见转移的认识。方法:纳入2例在扬州市第一人民医院经手术确诊为胃癌眼部转移的病例,对其临床资料进行回顾性分析。结果:2例患者均为老年男性,单眼患病,原发肿瘤均为胃腺癌。2例患者均表现为右眼疼痛和视力障碍,CT检查发现右眼占位,眼底检查1例发现眼底窥不清,1例发现颞下方视网膜青灰色隆起。1例患者未行胃癌根治术,转移时间为胃癌确诊后2个月,另一例转移时间为胃癌根治术后10个月。2例患者均行眼部手术,术后病理为转移性腺癌,未行放化疗,于术后1年内死亡。结论:胃癌眼部转移中右侧转移较少见。本组2例患者出现眼部转移症状至死亡均不足一年,提示转移癌恶性程度高。其治疗宜采取眼部局部治疗联合全身化疗。

Gastric cancer most often spreads to the liver, lung and bones, ocular metastatic tumor is considerably rare. Aims： To analyze the chnieal characteristics of ocular metastasis of gastric cancer for enhancing the recognition of this condition. Methods： A retrospective study was conducted in 2 cases of ocular metastasis of gastric cancer proved by ophthalmologic operation at Yangzhou No. 1 People＇s Hospital. Results： These two cases were elderly male with unilateral ocular metastasis of gastric adenocarcinoma, both of them presented with pain and impairment of vision in fight eye. Occupying lesion in right eye was demonstrated by CT in both cases. Fundus examination of the affected eye revealed unclear fnndus in one case and retinal gray bulge beneath the temple in another case. Metastatic symptom occurred 2 months after diagnosis of gastric cancer in one case with no radical surgery performed and in another case the metastatic symptom appeared 10 months postoperatively. Ophthalmologic operation was performed on affected eye in both cases, and metastatic adenocarcinoma was confirmed by histopathology. None of these two cases underwent chemotherapy or radiotherapy. Both of the two cases died within a year. Conclusions： Ocular metastasis of gastric cancer occurred in right eye is rarely seen. Both of the two patients enrolled in this study died less than 1 year since the occurrence of ocular metastasis, suggesting a high grade of malignancy. Local treatment combined with systemic chemotherapy might be a beneficial treatment modality.