Malignant Masquerade Syndromes
Authors:
prof. MUDr. Jarmila Heissigerová, Ph.D., MBA 1; E. Říhová 1; P. Svozílková 1; M. Brichová 1; D. Jeníčková 1; Z. Kovařík 1; J. Šach 2; P. Adam 3; I. Špička 4
Authors‘ workplace:
Oční klinika VFN a 1. LF UK, Praha, přednostka doc. MUDr. B. Kalvodová, CSc.
1; Ústav patologie FNKV a 3. LF UK, Praha, přednosta prof. MUDr. V. Mandys, CSc.
2; Laboratoř pro likvorologii OKBHI, Nemocnice Na Homolce, Praha, primář MUDr. Luděk Táborský
3; I. interní klinika VFN a 1. LF UK, Praha, přednosta doc. MUDr. Marek Trněný, CSc.
4
Published in:
Čes. a slov. Oftal., 65, 2009, No. 4, p. 131-138
Overview
Purpose:
To evaluate our experience with the diagnosis and treatment of malignant masquerade syndromes.
Methods:
A retrospective study of 46 patients treated for malignant masquerade syndromes at our Department for Diagnosis and Treatment of Uveitis, 1st Faculty of Medicine in Prague, between 1995 and 2008, was performed.
Results:
Eighty-nine patients with masquerade syndromes (7.2 %) from all 1233 patients with uveitis were included. Malignant masquerade syndromes were recognized in 46 patients (22 females and 24 males, mean age 55 years). The most frequent cause of malignant masquerade syndromes was intraocular non-Hodgkin lymphoma (26 patients). The primary diagnosis was idiopathic uveitis in many cases. The most valuable diagnostic procedure was analysis of intraocular fluids.
Conclusion:
Diagnosis of masquerade syndromes should be considered in all patients with idiopathic corticosteroid-resistant chronic uveitis. Timely diagnosis and treatment may in case of malignant masquerade syndromes improve prognosis and sometimes gain control over this potentially lethal disease.
Key words:
malignant masquerade syndrome, uveitis, diagnostic pars plana vitrectomy
Sources
1. Cassoux, N., Giron, A., Bodaghi, B., et al.: IL-10 measurement in aqueous humor for screening patients with suspicion of primary intraocular lymphoma. Invest Ophthalmol Vis Sci, 2007; 48: 3253–3259.
2. de Smet, M.D.: Management of non Hodgkin’s intraocular lymphoma with intravitreal methotrexate. Bull Soc Belge Ophtalmol, 2001; 91–95.
3. Fishburne, B.C., Wilson, D.J., Rosenbaum, J.T., et al.: Intravitreal methotrexate as an adjunctive treatment of intraocular lymphoma. Arch Ophthalmol, 1997; 115: 1152-1156.
4. Kim, S.K., Chan, C.C. Wallace, D.J.: Management of primary intraocular lymphoma. Curr Oncol Rep, 2005; 7: 74–79.
5. Nussenblatt, R.B., Whitcup, S.M. and Palestine, A.G.: Masquerade syndromes. In: Uveitis: Fundamentals and clinical practice, Mosby-Year Book, I., St. Louis, 1996: 385–395.
6. Plšková, J., Říhová, E., Svozílková, P., et al.: Léčba a klinické projevy primárního nitroočního lymfomu. Praktický lékař, 2005; 85: 622–625.
7. Rothova, A., Ooijman, F., Kerkhoff, F., et al.: Uveitis masquerade syndromes. Ophthalmology, 2001; 108: 386–399.
8. Řehůřek, J.: Maskující syndromy v onkologii dětského oka. Čes. a slov. Oftal., 1997; 53: 293–297.
9. Říhová, E., Havlíková, M., Rothová, Z., et al.: Maskující syndromy. Čes. a slov. Oftal., 1997; 53: 3–10.
10. Říhová, E., Šišková, A., Jandusová, J., et al.: Význam diagnosticko-terapeutické pars plana vitrektomie u endogenní uveitidy. Čes. a slov. Oftal., 2003; 59: 373–380.
11. Říhová, E., Šišková, A., Jandusová, J., et al.: Nitrooční lymfom - klinická studie 14 pacientů s NHL. Čes. a slov. Oftal., 2004; 60: 3–16.
12. Svozílková, P., Říhová, E., Heissigerová, J., et al.: Benigní maskující syndromy v diferenciální diagnostice uveitid. Čes. a slov. Oftal., 2008; 64: 175–184.
13. Theodore, F.H.: Conjunctival carcinoma masquerading as chronic conjunctivitis. Eye Ear Nose Throat Mon, 1967; 46: 1419–1420.
14. Whitcup, S.M., Stark-Vancs, V., Wittes, R.E., et al.: Association of interleukin 10 in the vitreous and cerebrospinal fluid and primary central nervous system lymphoma. Arch Ophthalmol, 1997; 115: 1157–1160.
Labels
OphthalmologyArticle was published in
Czech and Slovak Ophthalmology
2009 Issue 4
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