.: OKULISTYKA :.

Wydanie 1/2017
str. 38 - 41

Endoresekcja czerniaka naczyniówki – wskazania i ograniczenia metody

Endoresection of Choroidal Melanoma – Indications and Limitations

Agnieszka Kubicka-Trząska¹ , Krzysztof Morawski^1,2 , Bożena Romanowska-Dixon^1,2

¹ Klinika Okulistyki i Onkologii Okulistycznej Katedry Okulistyki Uniwersytetu Jagiellońskiego Collegium Medicum w Krakowie
Kierownik: prof. dr hab. n med. Bożena Romanowska-Dixon
² Oddział Kliniczny Okulistyki i Onkologii Okulistycznej Szpitala Uniwersyteckiego w Krakowie
Kierownik: prof. dr hab. n. med. Bożena Romanowska-Dixon

Summary: One of the most severe local complication after brachytherapy and proton beam therapy of choroidal melanoma is a “toxic tumor syndrome”. The tumor irradiation results in tumor cells DNA and vascular endothelium cells damage that leads to lysis, apoptosis and necrosis of the tumor. Cicatrizing and fibrotic tumor produces pro-inflammatory cytokines and growth factors which are responsible for the development of serious complications. The most severe and sight-threatening complications are neovascular glaucoma, exudative retinal detachment, maculopathy, intraocular inflammation. To avoid these severe complications it is suggested to combine irradiation with tumor endoresection as a secondary procedure.
Performing endoresection as a primary intervention is considered if radiotherapy has a high risk of causing severe visual loss and the tumor is present in the only one useful eye. Primary endoresection in association with histological and cytogenetic examinations are precious in predicting metastatic mortality in patient with choroidal melanoma.
The paper presents surgical technique, indications, limitations and complications associated with choroidal melanoma endoresection.

Słowa kluczowe: czerniak naczyniówki, endoresekcja, zespól guza toksycznego.

Keywords: choroidal melanoma, endoresection, toxic tumor syndrome.

powrót