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目的:探讨湖北地区13例眼眶转移癌的原发部位、影像学表现、治疗转归等临床特征。方法:回顾性分析武汉大学人民医院眼科中心2000年12月至2014年12月期间经过手术后病理明确诊断的13例眼眶转移癌的临床表现、原发部位和影像学表现等。结果:这项研究包括8名男性和5名女性,年龄范围36-72岁(平均50.4岁)。所有的患者来自湖北地区。其中原发肿瘤最常见的是肺癌5例(38.5%),其次是乳腺癌2例(15.4%),肝癌2例(15.4%),胃癌、结肠癌、甲状腺癌、子宫恶性平滑肌肉瘤各1例(7.7%)。最常见的临床表现是眼球突出(84.6%)、眼球运动受限(69.2%)、复视(61.5%)、眼睑肿胀(38.5%)、视力下降(38.5%)和结膜充血(23.1%)。主要治疗包括手术切除、放疗、全身化疗和观察。有随访资料的10例(76.9%)患者(平均随访时间23.5个月)。结论:在湖北地区眼眶转移癌最常见的原发性癌症为肺癌,其次是乳腺癌和肝癌。眼眶转移癌可有多种临床表现,全身性肿瘤患者出现上述临床表现时需考虑此病。该病的预后普遍较差,手术可以改善其生存质量。
Objective: To investigate the clinical features of 13 cases of orbital metastasis carcinoma in Hubei Province, including the primary site, imaging findings and treatment outcome. Methods: A retrospective analysis of the clinical manifestations, primary site and imaging findings of 13 cases of orbital metastatic carcinoma diagnosed by postoperative pathology from December 2000 to December 2014 in Department of Ophthalmology, People’s Hospital of Wuhan University. Results: This study included 8 males and 5 females, aged 36-72 years (mean, 50.4 years). All patients came from Hubei. The most common primary tumors were lung cancer in 5 cases (38.5%), followed by breast cancer in 2 cases (15.4%), liver cancer in 2 cases (15.4%), gastric cancer, colon cancer, thyroid cancer and uterine malignant leiomyosarcoma in 1 case (7.7%). The most common clinical manifestations were prominent eyeballs (84.6%), limited ocular motility (69.2%), diplopia (61.5%), eyelid swelling (38.5%), decreased visual acuity (38.5%) and conjunctival hyperemia (23.1%). The main treatment includes surgical resection, radiotherapy, systemic chemotherapy and observation. There were 10 patients (76.9%) with follow-up data (mean follow-up time of 23.5 months). Conclusion: The most common primary cancer of orbital metastasis in Hubei is lung cancer, followed by breast cancer and liver cancer. Orbital metastases can have a variety of clinical manifestations, systemic tumor patients need to consider the above clinical manifestations of the disease. The prognosis of the disease is generally poor, surgery can improve their quality of life.