新英格兰：眼结膜黑素瘤
一位78岁女性既往有青光眼史和糖尿病史。患者常规进行白内障检查，发现其右眼出现一红色斑和褐色斑丘疹病变。患者自诉该病变出现已1年，期间病变大小出现变化，偶有出血，但无疼痛、瘙痒或视力改变。行巩膜角膜切除术，并辅以冷冻治疗和外酒精外用。组织病理学检查示恶性结膜黑素瘤，伴原发性获得性不典型黑变病，厚1mm宽4mm。结膜黑素瘤可源于原发性获得性黑变病，常有局部转移，治疗后易复发。该患者辅助治疗有化疗和局部外用丝裂霉素。淋巴检查、骨扫描和头颈、胸腹CT检查未凶转移，治疗8月后未见复发。
A 78-year-old woman with a medical history of glaucoma, diabetes, and cataracts presented for a routine ophthalmologic visit, during which she was found to have an erythematous and brown maculopapular lesion in her right eye. She reported that the lesion had been present for approximately 1 year, during which time it had fluctuated in size and bled occasionally, but that it had not been associated with pain, pruritus, or visual changes. An excisional scleral keratectomy was performed, followed by cryotherapy and alcohol application. Histopathological analysis revealed malignant conjunctival melanoma associated with primary acquired melanosis with atypia, measuring 1.0 mm thick and 4.0 mm in diameter. Conjunctival melanoma can arise from primary acquired melanosis. It is often associated with regional metastases, and local recurrence after treatment is common. Adjuvant treatment in this patient included chemotherapy and topical mitomycin. Nodal examination, bone scan, and computed tomography of the head, neck, chest, and abdomen revealed no metastatic disease. Eighteen months after treatment, there was no evidence of recurrence.
来源于新英格兰
Conjunctival Melanoma
A 78-year-old woman with a medical history of glaucoma, diabetes, and cataracts presented for a routine ophthalmologic visit, during which she was found to have an erythematous and brown maculopapular lesion in her right eye. She reported that the lesion had been present for approximately 1 year, during which time it had fluctuated in size and bled occasionally, but that it had not been associated with pain, pruritus, or visual changes. An excisional scleral keratectomy was performed, followed by cryotherapy and alcohol application. Histopathological analysis revealed malignant conjunctival melanoma associated with primary acquired melanosis with atypia, measuring 1.0 mm thick and 4.0 mm in diameter. Conjunctival melanoma can arise from primary acquired melanosis. It is often associated with regional metastases, and local recurrence after treatment is common. Adjuvant treatment in this patient included chemotherapy and topical mitomycin. Nodal examination, bone scan, and computed tomography of the head, neck, chest, and abdomen revealed no metastatic disease. Eighteen months after treatment, there was no evidence of recurrence.
来源于新英格兰
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