眼眶转移性肿瘤难以诊断的情况

Grishina Elena
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摘要

引言:眼眶转移约占所有眼眶恶性肿瘤的15%。如果癌症患者有眼眶病变,每个人都会考虑眼眶转移。但癌症患者有时会有其他眼眶肿瘤或炎性眼眶病变。这项工作的目的是确定眼眶转移瘤的独特特征,以便与其他肿瘤和眼眶炎症病变进行鉴别诊断。材料和方法:对81例癌症患者进行回顾性、非对比性、图表回顾。74名患者(10名男性和64名女性,年龄18-87岁,中位数45岁)有眼眶转移,5名患者有第二个恶性眼眶肿瘤,主要是多发性恶性肿瘤(1名男性和4名女性,55–78岁,中位数61岁),2名男性(相应地64,66岁)有炎性眼眶病变。所有患者均接受了完整的眼科和全身检查。对眼眶病变进行形态学研究。结果:眼眶转移瘤的明显特点是:症状发展不快,但逐渐加重。通常,眼眶中只有一个界限清晰的肿瘤。转移瘤主要局限于眶前或眶中的眶上壁下。由于肿瘤的局限性,眼球突出会随着眼球移位而发展(机械性斜视)。眼眶转移瘤的主要症状是眼球活动受限。眼眶非霍奇金淋巴瘤的症状与眼眶转移的症状相同。急性眼眶炎症,模拟转移,有非典型的消除症状。结论:只有综合评估记忆数据、临床症状和活检样本的形态学检查结果,才能对眼眶转移瘤做出正确诊断。眼眶转移的姑息治疗提高了癌症患者的生活质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Orbital Metastatic Tumors Difficult Diagnostic Situations
Introduction: Orbital metastases compose about 15% of all orbital malignant tumors. If a cancer patient has got some orbital lesion everyone thinks about orbital metastasis. But a cancer patient sometimes has other orbital tumors or inflammatory orbital lesions. The aim of the work is to identify distinctive features of the orbit metastatic tumor for differential diagnosis with other tumors and inflammatory lesions in the orbit. Material and Methods: Retrospective, non-comparative, chart review of 81cancer patients. 74 patients (10 men and 64 women aged 18 – 87 years old, median 45 years old) had orbital metastases, 5 patients had the second malignant orbital tumor - primarily multiple malignant tumors (1 man and 4 women aged 55 – 78 years old, median 61 years old), and 2 men (64, 66 years old accordingly) had inflammatory orbital lesions. All the patients underwent complete ophthalmological and general examination. The orbital lesions were studied morphologically. Results: Distinctive features of the orbit metastatic tumor are the following: not rapid but gradual development of symptoms. As a rule there is a single well-delimited tumor in the orbit. Metastatic tumor is mainly localized under the upper wall of the orbit in the anterior or middle part of the orbit. Due to the localization of the tumor, exophthalmoses develop with displacement of the eyeball (mechanical strabismus). The main symptom of the orbital metastases is the limitation of the eye movements. The symptoms of orbital non-Hodgkin’s lymphoma are identical to the symptoms of orbital metastases. Acute orbital Inflammation, simulating metastases, had atypical erased symptoms. Conclusion: Only a comprehensive assessment of anamnesis data, clinical symptoms and the results of morphological examination of biopsy sample allows establishing the correct diagnosis of the orbital metastatic tumor. Palliative treatment of orbital metastases improves the quality of life of cancer patients.
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