脉络膜转移癌的临床和病理学特点分析

目的探讨脉络膜转移癌的临床表现及组织病理学特点。方法回顾性分析18例经组织病理学检查确诊为脉络膜转移癌患者的临床特征、组织病理学改变和原发肿瘤的来源、组织学分型。结果18例患者中大部分临床表现为严重视力障碍。眼底检查可见后极部视网膜下实性肿物,8例患者伴视网膜脱离。B超和CT检查显示眼内扁平或不规则的实性占位性病变。MRI扫描显示肿块在T1W上呈中高信号,T2W上呈低信号。病理学检查诊断为腺癌11例,鳞癌4例,未分化癌3例。来源于肺癌者10例（55％）,乳腺癌者4例（22％）。结论脉络膜转移癌以视力明显下降、眼底扁平实质性占位病灶为主要临床表现。原发肿瘤以肺癌发病率最高,组织病理学分型以腺癌常见。影像学检查有助于脉络膜转移癌的诊断。

Clinical and pathological analysis of choroidal metastatic carcinoma

Objective To study the clinical and pathological characteristics of choroidal metastatic carcinoma. Methods The clinical data, pathological character, primary tumor origin and histological classification of 18 patients with choroidal metastatic carcinoma were analyzed retrospectively. Results Most patients had severe visual impairment. Solid mass was seen in the posterior pole of the eyes in all 18 patients through ocular fundus examination, 8 cases had retinal detachment. B scan and CT examination found flat or irregular masses. MRI examination had been performed on 5 patients,high signal intensities on T1W and low signal intensities on T2W were found. Five patients were adenocarcinoma,4 were squamous carcinoma and 3 were undifferentiated carcinoma through pathological examination. Primary tumor was lung carcinoma in 10 cases (55% ) and breast carcinoma in 4 cases (22%). Conclusions Rapid decrease of visual acuity, flat neoplasm in ocular fundus and secondary retinal detachment are the main clinical characteristics of choroidal metastatic carcinoma. The most common primary tumor is lung carcinoma and the most common histopathological classification is adenocarcinoma. Imaging examination is helpful for the diagnosis of choroidal metastatic carcinoma.