报道一例发生在41岁中年女性左眼上睑的无色素性黑色素瘤，曾在当地医院误诊为霰粒肿。体检见左眼上睑结膜面一大小约2 cm × 2 cm红色肿物，手术切除肿物送病理检查，标本经10%福尔马林固定，常规石蜡包埋切片，HE染色及免疫组织化学染色。光镜下见肿瘤细胞呈片状及巢状排列，瘤细胞圆形及梭形，部分瘤细胞胞浆空泡状呈气球样形，部分细胞核仁明显。免疫组化显示肿瘤细胞S-100、HMB-45阳性，CK及EMA阴性，最终病理诊断为左眼上睑无色素性黑色素瘤。对于临床上患者年龄较大无典型霰粒肿特征的眼睑肿物，术后标本均应送病理检查以除外其它肿瘤的可能。

To report a case of amelanotic melanoma located in the leff upper eyelid misdiagnosed as chalazion in a 41-yearold woman. Examination showed a red 2 cm × 2 cm mass in the left upper palpebral conjunctiva. The tumor was excised and regular fixed in 10% formalin, embedded, sectioned, HE stained and immunohistochemistry stained. Histopathological examination revealed nests of round atypical tumor cells with vacuolated cytoplasm and sheets of spindle atypical tumor cells. Some tumor cells had conspicuous nucleoli. Immunohistochemistry some tumor cells were positive for melanocytic markers S-100, HMB-45 and negative for CK, EMA. So the pathological diagnosis was palpebral conjunctiva amelanotic melanoma in the leff upper eyelid. For the mass in palpebral conjunctiva of senile patients without typical characteristics of chalazion, the surgical specimen should be performed for pathologic examination to rule out other tumors.

目的：探讨多排 CT 对眼眶骨纤维异常增殖症（FD）的诊断价值及临床意义。

方法：回顾性分析 2002 年 4 月至 2009 年 8 月的我院（6 例）及中山大学中山眼科中心（12 例）收治的 18 例眼眶 FD 患者的多排 CT 表现，7 例取病变组织经病理证实，5 例经手术后病理证实，6 例具有典型的 CT 表现。

结果：本组眼眶 FD 可单发（5 例）、单骨多发（1 例）或多骨（12 例）发病，其中额骨 12 例，蝶骨 5 例，筛骨 2 例，颞骨 7 例。

结论：多排 CT 能在轴位、冠状位、矢状位上显示本病的病变特征及范围，有助于本病的早期诊断及指导临床制定合理的治疗方案。

Purpose: To evaluate the efficacy of multi-detector row CT (MDCT) findings in the diagnosis of fibrous dysplasia (FD) in orbital bone.

Methods: The MDCT manifestations of 18 cases of FD in orbital bone (6 cases from the 458th Hospital of PLA, 12 cases from the Zhongshan Ophthalmic Center of Sun Yat-sen University) collected from April 2002 to August 2009 were reviewed. Six cases were confirmed by biopsy, 5 cases were confirmed by operation and postoperative pathology, the remaining 6 cases were confirmed based on typical CT findings.

Results: FD in orbital bone could be originated from monostotic single lesion (5 cases), monostotic multiple lesions (1 case) or polyostotic multiple lesions (12 cases). Twelve lesions were originated in the frontal bone, 5 lesions in the sphenoid, 2 lesions in the ethmoid, 7 lesions in the temporal bone.

Conclusion: MDCT is very important in the diagnosis and treatment strategy of FD in orbital bone correctly. It helps identify the location and extension of the lesions based on the axial plane, coronal plane and sagittal plane view.