中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
Chinese Journal of Practical Ophthalmology
2015年
10期
1170-1172
,共3页
眶内容物剜除术%恶性黑色素瘤
眶內容物剜除術%噁性黑色素瘤
광내용물완제술%악성흑색소류
Orbital exenteration%Malignant melanoma
目的 评价眶内容物剜除术治疗结膜恶性黑色素瘤的临床效果.方法 回顾性病例研究.对2009年1月至2013年12月在上海市徐汇区中心医院眼科行眶内容物剜除术治疗结膜恶性黑色素瘤患者16例(16只眼)进行回顾性分析.结果 16例患者年龄46～82岁,平均(68.94±10.54)岁.来源于原发性获得性黑色素细胞增多症(PAM) 12例(12只眼),来源于色素痣或黑色素细胞瘤恶变4例(4只眼).8例(8只眼)累及眼睑皮肤面,14例(14只眼)累及睑球结膜和穹窿结膜,1例(1只眼)局限于角膜缘.2例(2只眼)瘤体高度小于1 mm,7例(7只眼)瘤体高度在1～3 mm,7例(7只眼)瘤体高度大于3 mm.16例患者均经活检确诊为恶性黑色素瘤后,13例(13只眼)行眼眶内容物剜除术,3例(3只眼)行联合游离皮瓣移植术.所有病例S100、HMB45阳性.随访时间5～60个月,平均(39.56±23.15)个月.2例(12.5％)在术后半年和2年复发,再次行手术切除,其中1例(6.25％)全身转移死亡.结论 较大范围的结膜恶性黑色素瘤及时行眶内容物剜除术具有良好疗效.
目的 評價眶內容物剜除術治療結膜噁性黑色素瘤的臨床效果.方法 迴顧性病例研究.對2009年1月至2013年12月在上海市徐彙區中心醫院眼科行眶內容物剜除術治療結膜噁性黑色素瘤患者16例(16隻眼)進行迴顧性分析.結果 16例患者年齡46～82歲,平均(68.94±10.54)歲.來源于原髮性穫得性黑色素細胞增多癥(PAM) 12例(12隻眼),來源于色素痣或黑色素細胞瘤噁變4例(4隻眼).8例(8隻眼)纍及眼瞼皮膚麵,14例(14隻眼)纍及瞼毬結膜和穹窿結膜,1例(1隻眼)跼限于角膜緣.2例(2隻眼)瘤體高度小于1 mm,7例(7隻眼)瘤體高度在1～3 mm,7例(7隻眼)瘤體高度大于3 mm.16例患者均經活檢確診為噁性黑色素瘤後,13例(13隻眼)行眼眶內容物剜除術,3例(3隻眼)行聯閤遊離皮瓣移植術.所有病例S100、HMB45暘性.隨訪時間5～60箇月,平均(39.56±23.15)箇月.2例(12.5％)在術後半年和2年複髮,再次行手術切除,其中1例(6.25％)全身轉移死亡.結論 較大範圍的結膜噁性黑色素瘤及時行眶內容物剜除術具有良好療效.
목적 평개광내용물완제술치료결막악성흑색소류적림상효과.방법 회고성병례연구.대2009년1월지2013년12월재상해시서회구중심의원안과행광내용물완제술치료결막악성흑색소류환자16례(16지안)진행회고성분석.결과 16례환자년령46～82세,평균(68.94±10.54)세.래원우원발성획득성흑색소세포증다증(PAM) 12례(12지안),래원우색소지혹흑색소세포류악변4례(4지안).8례(8지안)루급안검피부면,14례(14지안)루급검구결막화궁륭결막,1례(1지안)국한우각막연.2례(2지안)류체고도소우1 mm,7례(7지안)류체고도재1～3 mm,7례(7지안)류체고도대우3 mm.16례환자균경활검학진위악성흑색소류후,13례(13지안)행안광내용물완제술,3례(3지안)행연합유리피판이식술.소유병례S100、HMB45양성.수방시간5～60개월,평균(39.56±23.15)개월.2례(12.5％)재술후반년화2년복발,재차행수술절제,기중1례(6.25％)전신전이사망.결론 교대범위적결막악성흑색소류급시행광내용물완제술구유량호료효.
Objective To evaluate the effect of orbital exenteration in conjunctival malignant melanoma.Methods A retrospective cases analysis.The clinical features of 16 cases of conjunctival malignant melanoma and the follow-up data after orbital exenteration were analyzed.These cases were treated from January 2009 to December 2013.Results The mean age was (68.94±10.54) years and ranging from 46 years to 82 years, 12 cases arose from primary acquired melanosis (PAM), 4 cases from conjunctival nevi or melanocytoma, 8 cases involved the skin of eyelid, 14 cases involved the palpebral conjunctiva, bulbar conjunctiva and fornical conjunctiva, 1 case involved limbus only, 2 cases with the thickness of tumor less than 1mm, 7 cases with the thickness between 1mm and 3mm, 7 cases with the thickness more than 3mm.After final diagnosis by biopsy, 13 cases underwent orbital exenteration and 3 cases underwent orbital exenteration and free flap transplantation.The tumor cells were positively stained with S100 and HMB45.The mean follow-up period was (39.56±23.15) months and ranging from5 months to 60 months, 2 cases (12.5％) underwent reoperation caused the recurrences at 6 months and 2 years postoperation, 1 of which died from systematic metastasis.Conclusions It seems good effect of orbital exenteration in conjunctival malignant melanoma with extensive area.
