Mélanome primitif de la choroïde: étude de 12 cas

• Published in: Oncologie (Paris, France) France), 2010, Vol.12 (Suppl 1), p.125-131
• Main Authors: Kallel, R., Khabir, A., Ben Zina, Z., Makni, S., Chaabouni, S., Feki, J., Daoud, J., Sellami Boudawara, T.
• Format: Article
• Language: fre
• Subjects: Cas Clinique; Case Report; Choroid melanoma; Enucleation; Histologie; Histology; Immunohistochemical study; Immunohistochimie; Medicine; Medicine & Public Health; Mélanome de la choroïde; Oncology; Énucléation
• ISSN: 1292-3818; 1765-2839
• DOI: 10.1007/s10269-010-1965-9

Introduction: Choroidal primary melanoma is the most common primary intraocular malignant tumour. The diagnosis is based on ophthalmoscopy, fluorescent angiography, B-scan ultrasonography and histological exam. Tumour markers like Melan A, HMB-45 and Protein S100 add to diagnostic accuracy. Our objective is to discuss the clinical and pathological data of choroïdal primary melanoma of and the prognosis of this rare tumor. Patients and methods: We report twelve cases of choroidal primary melanoma during a period of 27 years (1980–2007). Results: There were eight men and four women ranging in age from 30 to 76 years (mean: 58 years). The most frequent symptom at presentation was decreased visual acuity. The ophtalmologic examination revealed a posterior pigmented tumour with retinal detachment in four cases. The ultra-sonography showed an intraocular hypoechoic tumour. Magnetic resonance (MRI), achieved in only six cases, suspected the diagnostic of melanoma. The fluorescent angiography was achieved in single case and showed a vascular tumour. Enucleation was performed in ten cases and an exentration in two cases; adjuvant radiotherapy was performed in two cases and chemotherapy in one case. The histologic exam with immunohistochimical study confirmed the diagnostic of choroidal melanoma. The outcome was favourable in six cases with with a middle average follow-up of 20 months, reccurence in three cases and two patients had hepatic metastasis, one of whom died; the last patient was lost sight of the fact. Conclusion: Enucleation is still performed for choroidal melanoma; however, the past decades, numerous eye salvaging therapies for the tumour have been developed. Résumé: Introduction: Le mélanome primitif de la choroïde (MPC) est une pathologie rare, il constitue cependant la tumeur intraoculaire primitive la plus fréquente chez l’adulte. Son diagnostic est anatomopathologique, couplé souvent à une étude immunohistochimique. Le but de notre travail est de discuter les particularités anatomocliniques et évolutives de cette tumeur rare. Patients et méthodes: Nous rapportons 12 cas de MPC diagnostiqués et pris en charge au CHU Habib-Bourguiba de Sfax sur une période de 27 ans (1980–2007). Résultat: Il s’agissait de huit hommes et quatre femmes ayant un âge moyen de 58 ans, avec des extrêmes de 30 et 76 ans. La symptomatologie clinique était dominée par une baisse de l’acuité visuelle. L’examen oculaire avait révélé dans la majorité des cas une tumeur postérie