脉络膜黑色素瘤的临床特征

The clinical characteristics of choroidal melanoma

目的探讨脉络膜黑色素瘤(CM)的临床特征。方法回顾性分析2012年1月至2017年12月河南省人民医院收治的45例CM患者的临床资料,总结患者的病史、临床表现、影像学检查、病理组织学检查、治疗和随访情况。结果 45例患者中曾被误诊为青光眼3例、白内障2例、视网膜脱离2例、病毒性角膜炎1例、角膜溃疡1例、脉络膜血管瘤1例。主要症状为视力下降。3例行眶内容物摘除术,42例行眼球摘除术。病理组织学类型为梭形细胞型41例,混合型3例,上皮细胞型1例。至少随访1 a,失访10例,完成随访的35例中发生转移4例,死亡7例。结论 CM的临床表现多样,缺乏特异性,需结合多种检查方法进行诊断,病理组织学类型以梭形细胞型为主,治疗方式多样,需要个体化,发生转移后生存率明显降低。

Objective To analyze the clinical characteristics of choroidal melanoma(CM).Methods The clinical data of 45 patients with CM admitted to Henan Provincial People’s Hospital from January 2012 to December 2017 were retrospectively analyzed,and their medical history,clinical manifestations,imaging examination,histopathological examination,treatment and follow-up were summarized.Results Among the 45 patients,3 cases were misdiagnosed as glaucoma,2 cases of cataract,2 cases of retinal detachment,1 case of viral keratitis,1 case of corneal ulcer and 1 case of choroidal hemangioma.The main symptom was decreased vision.Excision of orbital contents was performed in 3 cases and enucleation of eyeball in 42 cases.The histopathological types included 41 cases of spindle cell type,3 cases of mixed type,and 1 case of epithelial cell type.Follow-up for 1 year at least,there were 10 cases missed and 4 cases of metastasis and 7 cases of death occurred in 35 cases with follow-up completed.Conclusion The clinical manifestations of CM are diverse and lack specificity,and it is necessary to combine multiple inspection methods to diagnosis.The histopathological type is mainly spindle-shaped cell type.The treatment methods are diverse and need to be individualized.The survival rate after metastasis is significantly reduced.