intraocular metastases
Introduction
Introduction to intraocular metastatic tumor Intraocular metastatic tumors are relatively rare, because the ophthalmic artery and the internal carotid artery are at right angles, so the tumor embolus in the blood flow tends to stay in the intracranial (brain and meninges) due to the blood flow velocity, and is not easy to enter through the ophthalmic artery. In the eye. There are many monocular ones, and the left eye is more than the right eye. Because the left common carotid artery directly occurs from the aortic arch, the tumor embolus can easily enter the left eye through the upper side, and the right side needs to bypass the innominate artery, which is difficult. There are also two eyes at the same time, but rare. More cancer than sarcoma or melanoma, because the incidence of systemic cancer is higher than sarcoma or melanoma, the most common is breast cancer, followed by lung cancer, stomach cancer and so on. Metastatic tumors occur mostly in the choroid, because the number of short ciliary arteries is more than that of the posterior ciliary artery and the ciliary anterior artery, so it occurs in the choroid more than the iris and ciliary body. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of infection: non-infectious Complications: ocular protrusion, corneal staphyloma
Cause
Intraocular metastatic tumor etiology
There are many single eyes, more left eyes than right eyes, because the left common carotid artery occurs directly from the aortic arch, the tumor embolus is easy to enter the left eye through the upper part, and the right side needs to bypass the innominate artery, which is difficult and has both eyes at the same time. The onset, but rare, more cancer than sarcoma or melanoma, because the incidence of systemic cancer is higher than sarcoma or melanoma, the most common of which is breast cancer, followed by lung cancer, gastric cancer, etc., metastatic tumors occur mostly in Choroidal.
Prevention
Intraocular metastatic tumor prevention
There are no effective precautions, as long as it prevents the metastasis of other tumors.
Complication
Intraocular metastatic tumor complications Complications, ocular protrusion, corneal staphyloma
The tumor penetrates the sclera into the sac, causing the eyeball to protrude; it can also cause corneal staphyloma or piercing the cornea to grow outside the ball, and even protrude beyond the cleft palate, grow into a huge tumor, or appear to the whole body.
Symptom
Intraocular metastatic tumor symptoms Common symptoms Visual impairment
Ocular symptoms: It is one of the systemic symptoms, usually it is transferred to the eye in the late stage, but it is also transferred to the eye in the early stage.
Visual impairment: early symptoms often have central dark spots and vision loss, because intraocular metastatic tumors occur mostly in the posterior pole, especially the choroidal capillary layer of the macula, such as lung cancer and pharyngeal cancer. In severe cases, secondary to secondary can occur. Sexual glaucoma.
Examine
Examination of intraocular metastatic tumors
The course of metastatic tumors develops rapidly, often accompanied by fever, weight loss, fatigue and primary tumor mass, metastatic lymphadenopathy and other symptoms. In most cases, high levels of immune complexes (>25g/ml) can be detected. Carcinoembryonic antigen greater than 10ng / ml, suggesting the possibility of metastatic disease, the plane of vision of the eye can find the absolute dark spots consistent with the tumor, in addition to fundus fluorescein angiography, B-ultrasound, CT examination.
Diagnosis
Diagnosis and differentiation of intraocular metastatic tumor
In the differential diagnosis should pay attention to: abnormal retinal development; post-crystal fibrosis; metastatic endophthalmitis; exudative retinitis (Coats disease): occurred in male adolescents 7-8 years old, mostly monocular, progression Slow, eye examination, there is little opacity in the vitreous, white exudative detachment of the retina, extensive telangiectasia and bleeding point and cholesterol crystallization, and Rb occurs in infants under 5 years old, vitreous opacity is more common, retina Detachment is solid, vascular engorgement and new blood vessels are mostly limited to the tumor area. In addition, from X-ray photographs, CT and ultrasound diagnosis are significantly different, except for Coats disease.
