Scleritis as an initial manifestation of choroidal malignant melanoma.
Scleritis as an initial manifestation of choroidal malignant melanoma.
复制标题
巩膜炎是脉络膜恶性黑色素瘤的首发表现。
DOI：
10.1016/s0161-6420(92)31744-0
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发表时间：
1992
期刊：
影响因子：
13.7
通讯作者：
Buettner,H
中科院分区：
文献类型：
--
作者：
Yap,EY;Robertson,DM;Buettner,H
目的：本文的目的是介绍脉络膜恶性黑色素瘤可以伪装成巩膜炎，从而混淆其诊断的不寻常情况。方法：报告3例脉络膜斑块样恶性黑色素瘤，初步检查具有巩膜炎的特征。导致他们最终正确诊断的事件也被提出。结果：每例患者均出现眼痛、视力模糊、前房和/或玻璃体腔细胞反应、渗出性视网膜脱离，并伴有界限不清、相对平坦、色素变化的脉络膜肿块。在所有三个病例中，炎症成分对皮质类固醇治疗反应迅速，并伴有视力改善。在两只眼睛中，脉络膜肿块的缩小伴随着皮质类固醇治疗，为巩膜炎的有效诊断提供了支持。通过显示脉络膜肿块的扩张，检查连续眼底照片影响了对疑似恶性脉络膜黑色素瘤的摘除眼睛的决定。结论：临床医生应警惕脉络膜恶性黑色素瘤可能伪装成巩膜炎的情况。通过眼科检查、超声检查、眼底摄影和随后的顺序检查进行仔细的评估是达到正确诊断所必需的。
Purpose:The purpose of this article is to present the unusual circumstances in which malignant melanoma of the choroid can masquerade as scleritis, thus confounding its diagnosis.Methods:Three cases of plaque-like malignant melanomas of the choroid are reported that, on initial examination, had features of scleritis. The events leading to their eventual correct diagnosis also are presented.Results:In each case, there was ocular pain, blurred vision, anterior chamber and/or vitreous cavity cellular reaction, and an exudative retinal detachment associated with an ill-defined, relatively flat variably pigmented choroidal mass. In all three cases, the inflammatory component responded promptly to corticosteroid treatment and was accompanied by visual improvement. In two eyes, shrinkage of the choroidal mass accompanied the corticosteroid treatment, lending support to a working diagnosis of scleritis. By demonstrating expansion of the choroidal masses, examination of sequential fundus photographs influenced the decision to enucleate the eyes for presumed malignant choroidal melanoma.Conclusion:Clinicians should be alert to the circumstances in which malignant melanomas of the choroid can masquerade as scleritis. Careful evaluation by ophthalmoscopy, ultrasonography, fundus photography, and subsequent sequential examination is necessary to arrive at the correct diagnosis.