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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。
Objective To investigate the clinical manifestations and histopathological features of choroidal carcinoma. Methods The clinical features, histopathological changes and the origin and histological type of 18 patients with choroidal metastasis confirmed by histopathology were analyzed retrospectively. Results Most of the 18 patients had severe visual impairment. Fundus examination showed subretinal real posterior pole mass, 8 patients with retinal detachment. B-ultrasound and CT examination showed flat or irregular intraocular space-occupying lesions. MRI scans showed medium and high signals on T1W and low signals on T2W. Pathological examination diagnosed as adenocarcinoma in 11 cases, squamous cell carcinoma in 4 cases, undifferentiated carcinoma in 3 cases. 10 cases (55%) were from lung cancer and 4 cases (22%) were breast cancer. Conclusion Choroidal metastasis in patients with decreased visual acuity, flat fundus occupying lesions as the main clinical manifestations. The highest incidence of primary lung cancer, histopathological classification of adenocarcinoma common. Imaging studies can help diagnose choroidal metastases.