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National Cancer Institute®
Ultima Vez Modificado: 1 de mayo del 2002
UI - 11917800
AU - Groh MJ; Kuchle M; Naumann GO
TI - [Corneal neural paralysis after block excision including the 3 and 9 o'clock meridian]
SO - Ophthalmologe 2002 Mar;99(3):181-2
AD - Augenklinik mit Poliklinik, Universitat Erlangen-Nurnberg, Schwabachanlage 6, 91054 Erlangen. firstname.lastname@example.org
PURPOSE: Corneal innervation is mainly supported by the long posterior ciliary nerves. Anatomically, the long ciliary nerves run with the long ciliary arteries at 3 and 9 o'clock. The aim of this retrospective study was to find out if block excision of anterior uveal tumors or epithelial ingrowth located at the 3 or 9 o'clock position of the limbal circumference causes corneal neuroparalysis. PATIENTS AND METHODS: in our department (92 block excisions because of anterior uveal tumors and 59 because of cystic epithelial ingrowth to the anterior chamber). In 27 patients, anterior uveal tumors or cystic epithelial ingrowth were located at the 3 or 9 o'clock position of the limbal circumference (14 patients with cystic epithelial ingrowth and 13 patients with anterior uveal tumors). Mean age of all patients was 54.4 +/- 15.7 years at the time of surgery. Mean diameter of the block excision was 10.7 +/- 4.5 mm for tumor-patients and 9.0 +/- 1.2 mm for patients with anterior chamber cysts. Mean follow-up time was 93.6 +/- 43 months. RESULTS: Only 1 of 27 patients exhibited a moderate neuroparalytic corneal ulcer during the follow-up time. In the remaining 26 patients, no signs of clinically relevant corneal neuroparalysis such as epithelial disorders or neuroparalytic ulcers were found. CONCLUSION: Block excision of tumors or cystic epithelial ingrowth located at the 3 or 9 o'clock position of the limbal circumference did not lead to severe neuroparalytic disorders of the host cornea. This may be an important factor in postoperative management of patients undergoing block excision and corneoscleral grafting.
UI - 11917803
AU - Mueller AJ; Freeman WR; Folberg R; Schaller UC; Kampik A
TI - [The Munich/San Diego/Iowa City Collaboration (MuSIC). MuSIC Report I: Design , characteristics of the collective and preliminary results]
SO - Ophthalmologe 2002 Mar;99(3):193-9
AD - Augenklinik der Ludwig-Maximilians-Universitat, Mathildenstrasse 8, 80336 Munchen.
BACKGROUND: We have previously shown that histologically described microcirculation patterns (MCP) can be visualized with indocyanine green (ICG) angiography. We have designed a prospective study to evaluate the prognostic value of these angiographically imaged MCP in small choroidal melanocytic lesions. In this report we describe the design of the study, characterize the patient collective, and present the first results. PATIENTS AND METHODS: In this prospective nonrandomized observational study, unilateral choroidal melanocytic lesions with 1.5-5.5 mm maximum apical height are observed until growth is determined according to defined criteria. Variables are demographic parameters, subjective symptoms, subretinal fluid, location and dimension of tumor, hemorrhage, color, orange pigment, and MCP determined by ICG angiography: normal, straight, parallel without crosslinking, parallel with crosslinking, arcs without branching, arcs with branching, loop, and network. RESULTS: Seventy patients (22 males, 48 females; age: 33-88 years, median: 64 years) have been included up to now: 19 tumors showed growth so far (time to growth: 51-946 days, median: 127 days). The following parameters were statistically significantly correlated with time to tumor growth: flashes (p = 0.082), orange pigment (p = 0.012), subretinal fluid (p < 0.001), maximum basal tumor diameter (p = 0.001), maximum apical tumor height (p < 0.001), parallel with crosslinking (p < 0.001), arcs with branching (p = 0.006), loop (p < 0.001), and network (p < 0.001). Of these, complex MCP (parallel with crosslinking, arcs with branching, loop and/or network) showed the strongest correlation with time to tumor growth in a Cox regression model. Based on our data, the positive predictive value of imaging complex MCP (for growth within 12 months) is 78% and the negative predictive value is 98%. CONCLUSION: Our patient collective demonstrates comparable prognostic parameters for time to growth as described in the literature. In addition, the ICG angiographic detection of complex MCP is more strongly predictive of the time to growth than other clinically determinable factors. Thus, we recommend this examination for patients with small choroidal melanocytic lesions, if the patient is to be counseled regarding the likely biologic behavior of his tumor.
UI - 11766025
AU - Esmaeli B; Eicher S; Popp J; Delpassand E; Prieto VG; Gershenwald JE
TI - Sentinel lymph node biopsy for conjunctival melanoma.
SO - Ophthal Plast Reconstr Surg 2001 Nov;17(6):436-42
AD - Department of Plastic Surgery, The University of Texas M. D. Anderson Cancer Center, Houston 77030, USA.
OBJECTIVE: To investigate the feasibility and safety of preoperative lymphoscintigraphy and sentinel lymph node (SLN) biopsy for conjunctival melanoma. METHODS: A 49-year-old man with a biopsy-proven malignant melanoma of the conjunctiva (caruncle) underwent preoperative lymphoscintigraphy and SLN biopsy using a technique in which both isosulfan blue dye and technetium Tc 99 m sulfur colloid were injected in the subconjunctival space around the primary lesion. The conjunctival melanoma was excised just before identification and removal of the SLNs. The SLNs were excised along with concomitant dissection of their associated lymph node basins. The SLNs were evaluated histologically using serial sectioning and immunohistochemical staining with antisera against the S-100 protein and the melanoma antigen HMB-45. RESULTS: Three SLNs were identified in the left submandibular and the left upper and middle jugular lymph node basins during the preoperative lymphoscintigraphy. The same three SLNs were successfully identified in the operating room. The SLNs were histologically negative, and the immunohistochemical staining against S-100 and HMB-45 was also negative. We did not observe any immediate adverse effects on the globe or the periocular structures from lymphatic mapping and SLN biopsy. By 24 hours after injection of blue dye, only a faint trace of blue was visible on the ocular surface. CONCLUSIONS: Preoperative lymphoscintigraphy and SLN biopsy can be performed safely in patients with conjunctival melanoma. A larger study is planned to determine the sensitivity of this technique for the detection of occult regional nodal disease in patients with conjunctival melanoma.
UI - 11794392
AU - Peyman GA; Cheema RA; Lagouros PA
TI - Endoresection of a ciliochoroidal melanoma.
SO - Can J Ophthalmol 2001 Dec;36(7):411-4; discussion 414-5
AD - Department of Ophthalmology, School of Medicine, Tulane University Health Sciences Center, New Orleans, LA 70112-2699, USA.
UI - 11955750
AU - Hermann RM; Pradier O; Lauritzen K; Ott M; Schmidberger H; Hess CF
TI - Does escalation of the apical dose change treatment outcome in beta-radiation of posterior choroidal melanomas with 106Ru plaques?
SO - Int J Radiat Oncol Biol Phys 2002 Apr 1;52(5):1360-6
AD - Department of Radiotherapy and Radiooncology, University of Goettingen, Goettingen, Germany. email@example.com
PURPOSE: To show the results of treating posterior uveal melanomas with 106Ru plaque beta-ray radiotherapy and to review and discuss the literature concerning the optimal apical dose prescription (100 vs. 160 Gy). METHODS AND MATERIALS: Forty-eight patients with uveal melanomas (median height 3.85 mm + 1 mm sclera) were treated with ruthenium plaques. The median apical dose was 120 Gy, the median scleral dose 546 Gy. RESULTS: After 5.8 years of follow-up, the overall 5-year survival rate was 90%, the disease specific 5-year survival rate was 92% (3 patients alive with metastasis). Six percent received a second ruthenium application, 10% of the eyes had to be enucleated. Local control was achieved in 90% of the patients with conservative therapy alone. Central or paracentral tumors showed 50% of the pretherapeutic vision after 4 years, and 80% of the vision was preserved in those with peripheral tumors. The main side effects were mostly an uncomplicated retinopathy (30%); macular degeneration or scarring led to poor central vision in 30% of cases. CONCLUSION: Brachytherapy with ruthenium applicators is an effective therapy for small- and medium-size posterior uveal melanomas. Our results are comparable to other series. The treatment outcome does not seem to be capable of improvement by increasing the apical dose. An internationally accepted model for defining the dosage in brachytherapy is needed.
UI - 11292427
AU - Demirci H; Shields CL; Shields JA; Eagle RC Jr; Honavar SG
TI - Bilateral breast metastases from choroidal melanoma.
SO - Am J Ophthalmol 2001 Apr;131(4):521-3
AD - Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
PURPOSE: To report an unusual case of solitary sequential bilateral breast metastases from choroidal melanoma. METHOD: Case report. RESULTS: A 48-year-old woman with a large choroidal melanoma in the left eye was treated with Iodine-125 brachytherapy and responded satisfactorily with decrease in tumor thickness. Thirty-seven months after treatment, she developed a solitary, circumscribed melanoma metastasis to the right breast, and 54 months after treatment, a similar metastasis was detected in her left breast. Both breast tumors were managed with lumpectomy. Systemic examination including magnetic resonance imaging of abdomen, chest, and head have been performed regularly and have been normal. At 61 months after treatment, the patient has no clinical evidence of metastatic disease elsewhere. CONCLUSIONS: Uveal melanoma rarely metastasizes to breast tissue. A breast nodule in a patient with a history of uveal melanoma is most likely a primary breast tumor but may rarely represent a metastasis from uveal melanoma.
UI - 11904462
AU - Cartsburg O; Kallen C; Hillenkamp J; Sundmacher R; Pomjanski N; Bocking
TI - A Topical mitomycin C and radiation induce conjunctival DNA-polyploidy.
SO - Anal Cell Pathol 2001;23(2):65-74
AD - Department of Ophthalmology, Heinrich-Heine University, Dusseldorf, Germany. firstname.lastname@example.org
INTRODUCTION: Atypical cell changes often occur following treatment of premalignant or malignant conjunctival neoplasias with topical mitomycin C (MMC) and/or radiation. These reactive, non-neoplastic alterations of the conjunctival epithelium can be a differential diagnostic problem. Our aim was to investigate changes in the nuclear DNA-distribution of conjunctival epithelial cells after MMC- and radiation therapy by DNA-image-cytometry. METHODS: Conjunctival brush smears were obtained from 13 patients (13 eyes) with squamous cell carcinomas and six patients (6 eyes) with conjunctival malignant melanomas in situ before, during and after treatment. The patients were treated with MMC-drops (0.02% or 0.04%) alone (n=12), with radiation therapy (n=3) or both (n=4). At first, the obtained brush smears were evaluated by cytology. Secondly, after Feulgen restaining, the DNA content of reactively changed cells was determined using the AutoCyte-QUIC-DNA workstation. RESULTS: We observed euploid DNA-polyploidy and cytomorphological changes in all patients (19/19). We considered these alterations as reactive to treatment. Four patients showed their greatest DNA-stemline at 4c and 15 patients at 8c. This effect was observed during and following MMC-drops and/or radiation and remained stable in 94% of all patients after a mean follow-up of 22.5 months (SD 15.4). In five cases image cytometry additionally demonstrated DNA-stemline aneuploidy as an evidence of tumor recurrence. CONCLUSION: Measurements of DNA-content revealed euploid polyploidisation of morphological suspicious but benign squamous cells which is the biologic correlate of well known secondary morphologic changes following topical chemotherapy and/or radiation. DNA-image-cytometry is a useful tool in the differention of euploid polyploidization as a sign of reactive cell changes following treatment and tumor recurrences.
UI - 11986095
AU - Vaziri M; Buffam FV; Martinka M; Oryschak A; Dhaliwal H; White VA
TI - Clinicopathologic features and behavior of cutaneous eyelid melanoma.
SO - Ophthalmology 2002 May;109(5):901-8
AD - Department of Pathology, Vancouver General Hospital and University of British Columbia, Vancouver, British Columbia, Canada.
OBJECTIVE: To study the clinical and histopathologic features of cutaneous eyelid melanomas and identify prognostic factors in the behavior of such tumors. DESIGN: Retrospective observational case series. PARTICIPANTS: Twenty-three patients with cutaneous eyelid melanomas without conjunctival involvement. METHODS: Patients' charts were reviewed for clinical information, treatment procedure, and disease course (updated at the time of study). Histopathologic sections from all surgical procedures were reviewed. MAIN OUTCOME MEASURES: Histologic type of melanoma, tumor growth phase, Clark's level of invasion, tumor thickness, and other microscopic features were evaluated in each case. The width of excision margins was considered and measured histologically when possible. RESULTS: There was no gender predilection. The lower eyelid was more frequently involved than the upper eyelid or canthi. Seventeen cases (74%) were invasive, and six (26%) were in situ melanomas. Lentigo maligna melanoma was the most common histologic type, accounting for 61% (14 cases) of all melanomas and 53% (9 cases) of invasive melanomas. Superficial spreading melanoma accounted for 22% (5 cases) and nodular melanoma for 17% (4 cases) of all melanomas. Surgical excision, as the treatment of choice, was incomplete in nine cases, two thirds of which were lentigo maligna melanoma (in situ or invasive). Tumor reappeared in 77.8% of these cases. Fourteen patients had initial narrow excisions, and three of them (21.4%) had local recurrences. Although recurrence occurred in one each of our "in situ," "thin," and "thick" melanomas, it proceeded to distant metastases and death only in the "thin" one. Adjuvant radiotherapy was used in six patients with successful disease control in two cases. CONCLUSIONS: Eyelid skin melanomas have a relatively good clinical prognosis. The histologic type and thickness of the primary melanoma were not clearly related to the clinical behavior once they were completely excised. The use of very narrow excisions of 5 mm or less was associated with greater frequency of local recurrence. Lentigo maligna melanomas were the largest tumors at presentation and, despite being thinner, were a greater surgical challenge. This type of melanoma is almost certainly underdiagnosed by ophthalmologists.
UI - 11986096
AU - Haas A; Pinter O; Papaefthymiou G; Weger M; Berghold A; Schrottner O;
TI - Mullner K; Pendl G; Langmann G Incidence of radiation retinopathy after high-dosage single-fraction gamma knife radiosurgery for choroidal melanoma.
SO - Ophthalmology 2002 May;109(5):909-13
AD - Department of Ophthalmology, Karl-Franzens University, Graz, Austria.
OBJECTIVE: To investigate the incidence and clinical findings of radiation retinopathy after single-fraction high-dose gamma knife radiosurgery for choroidal melanoma. DESIGN: Retrospective noncomparative interventional case series. PARTICIPANTS: Thirty-two patients with choroidal melanoma. METHODS: Review of charts, color fundus photographs, and fluorescein angiograms of 32 choroidal melanoma patients after radiosurgery. All patients were treated with the Leksell gamma knife in one fraction with a marginal dose between 40 and 80 Gy (median, 50 Gy) and were followed for at least 24 months (or until enucleation because of complications secondary to radiation). MAIN OUTCOME MEASURES: Any clinical feature of radiation retinopathy and neovascular glaucoma. RESULTS: During a mean follow-up of 38 months (range, 6-81 months) we found radiation retinopathy in 84% of our patients. The most common findings in these patients were intraretinal hemorrhages with an incidence of 70%, macular edema and capillary nonperfusion in 63%, and hard exudates in 52% of the patients. Less common were microaneurysms in 30% and retinal neovascularization in 22%. The time of onset of the various radiation-associated retinal findings ranged between 1 and 22 months. Forty-seven percent of all patients developed neovascular glaucoma. In our study there was no correlation between radiation dosage applied and clinical findings. CONCLUSIONS: Single-fraction high-dose Leksell gamma knife radiosurgery of choroidal melanomas with a median marginal dose of 50 Gy is highly associated with early radiation retinopathy and with neovascular glaucoma.
UI - 11986097
AU - Tuomaala S; Aine E; Saari KM; Kivela T
TI - Corneally displaced malignant conjunctival melanomas.
SO - Ophthalmology 2002 May;109(5):914-9
AD - Ocular Oncology Service, Department of Ophthalmology, Helsinki University Central Hospital, Helsinki, Finland.
PURPOSE: To characterize and classify malignant conjunctival melanomas with exclusively corneal invasive growth. DESIGN: Population-based, nationwide retrospective cross-sectional study. PARTICIPANTS: Patients with primary malignant conjunctival melanoma diagnosed between 1967 and 2000 in Finland. METHODS: On the basis of all available clinical and histopathologic data of tumors diagnosed during the study period, malignant conjunctival melanomas that first demonstrated invasive growth on the cornea without evidence of conjunctival tumors other than primary acquired melanosis were identified, their prevalence calculated, and their characteristics reviewed. On the basis of these cases and literature data, a classification for "corneal melanoma" was developed. MAIN OUTCOME MEASURES: Frequency and type of corneal involvement, recurrence, and survival. RESULTS: Patients with exclusively corneal invasive tumor accounted for 5% (95% confidence interval, 1-12) of 85 consecutive primary conjunctival melanomas. Two were separated from the limbus by clear cornea (type I), and two paralleled but did not invade the limbal conjunctiva (type II). Two were associated with clear evidence of primary acquired melanosis. None of the tumors recurred after local excision, and no metastases were observed during a median follow-up of 2 years 5 months (range, 1 year 8 months-7 years 10 months). CONCLUSIONS: Primary malignant conjunctival melanomas can grow on the cornea without conjunctival involvement other than acquired melanosis. They are easily removed and do not cause lymphatic metastases. The term "corneally displaced malignant conjunctival melanoma" would best describe their supposed conjunctival origin and actual corneal location.
UI - 11973396
AU - Sharma MC; Shields CL; Shields JA; Eagle RC Jr; Demirci H; Wiley L
TI - Benign lymphoid infiltrate of the iris simulating a malignant melanoma.
SO - Cornea 2002 May;21(4):424-5
AD - Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
PURPOSE: To report a clinicopathologic correlation of an unusual benign lymphocytic iris mass in a patient who had no systemic lymphoproliferative disease. METHODS: Case report. RESULTS: A 49-year-old man developed a circumscribed, tan lesion in his left iris. The lesion was suspected clinically to be an atypical iris melanoma. Histopathologic studies of the resected mass revealed a solid tumor that was comprised of lymphocytes and histiocytes. Immunohistochemical studies identified that most of the cells were T lymphocytes. The histopathologic diagnosis was atypical lymphoid infiltrate. Workup for systemic lymphoma and Epstein-Barr virus infection was negative. CONCLUSION: Lymphoid infiltrate can manifest as a solitary mass that can simulate an iris melanoma.
UI - 11906300
AU - Stoffelns BM
TI - Primary transpupillary thermotherapy (TTT) for malignant choroidal melanoma.
SO - Acta Ophthalmol Scand 2002 Feb;80(1):25-31
AD - Department of Ophthalmology, Johannes Gutenberg University Mainz, Germany. email@example.com
PURPOSE: To evaluate the efficacy of transpupillary thermotherapy (TTT) as the only method of treatment for small choroidal melanoma. PATIENTS AND METHODS: In a prospective non-randomized analysis, 20 patients with primary choroidal melanoma (posterior to the equator with base < or = 2 and thickness < or = 4.5 mm) were treated with TTT as the only method of treatment (diode laser at 810 nm, beam diameter 3 mm, power setting 0.3-0.9 W, exposure time 20-37 min). During follow-up of at least 6 months, clinical aspects, ultrasonographic tumour thickness, fluorescein and indocyanine green angiographic patterns, visual acuity and ocular side-effects were recorded. RESULTS: In 17 eyes the tumour regressed significantly within 3 months after one treatment session (to a flat chorioretinal scar in 15 eyes). Despite a clinically flattened chorioretinal scar, fluorescein and indocyanine green angiography revealed that choriocapillary vessels in the heat-treated areas of 15 eyes remained perfused. Three amelanotic melanomas showed almost no response to TTT after repeated treatment at higher power settings. Visual acuity remained unchanged or improved in 12 eyes. Ocular side-effects included posterior synechia of the iris (1), macular oedema (2) and temporary retrobulbar pain (2). No patient showed tumour recurrence or metastases during follow-up. CONCLUSIONS: Preliminary results obtained by this study demonstrate good efficacy and visual outcome following TTT as the only method of treatment for small choroidal melanoma. However, indocyanine green angiographic findings suggest that tissue damage in the choroidal layer might be less effective, which perhaps may lead to a higher rate of tumour regrowth. Long-term follow-up is required to obtain data on late ocular side-effects, tumour recurrence and metastasis.
UI - 11914215
AU - Boyd SR; Tan DS; de Souza L; Neale MH; Myatt NE; Alexander RA; Robb M;
TI - Hungerford JL; Cree IA Uveal melanomas express vascular endothelial growth factor and basic fibroblast growth factor and support endothelial cell growth.
SO - Br J Ophthalmol 2002 Apr;86(4):440-7
AD - Department of Pathology, Institute of Ophthalmology, University College London, Bath Street, London EC1V 9EL, UK.
BACKGROUND: Tumour microvascularity is a significant determinant of prognosis for a large number of different tumours, including uveal melanoma. The development of blood vessels within these and other tumours is partly controlled by soluble pro-angiogenic cytokines, of which basic fibroblast growth factor (bFGF) and vascular endothelial growth factor-A (VEGF) are the best described. METHODS: Because VEGF has been inconsistently found within uveal melanomas and bFGF is described as an autocrine growth factor in cutaneous melanoma, the authors looked at the expression of these cytokines in uveal melanomas using immunohistochemistry and reverse transcriptase polymerase chain reaction (RT-PCR). The cross talk between uveal melanoma cells and endothelial cells was then assessed in an in vitro co-culture model. RESULTS: While most tumour cells expressed bFGF at the protein level by immunohistochemistry (89%), relatively few (22%) expressed VEGF, and this was of limited extent. All 20 tumours tested by RT-PCR contained mRNA for both bFGF and VEGF. Co-culture experiments using an ATP based bioassay showed that uveal melanomas could support the growth of a rat brain endothelial cell line (GPNT) and human umbilical vein endothelial cells (HUVEC), and that this could be modulated by cytokines and anti-cytokine antibodies. CONCLUSION: These results suggest that angiogenesis within uveal melanoma may be the result of a complex interplay between endothelial and tumour cells, and that bFGF and VEGF could play a part.
UI - 11914216
AU - Boyd SR; Tan D; Bunce C; Gittos A; Neale MH; Hungerford JL;
TI - Charnock-Jones S; Cree IA Vascular endothelial growth factor is elevated in ocular fluids of eyes harbouring uveal melanoma: identification of a potential therapeutic window.
SO - Br J Ophthalmol 2002 Apr;86(4):448-52
AD - Department of Pathology, Institute of Ophthalmology, University College London, Bath Street, London EC1V 9EL, UK.
BACKGROUND: Improved local treatment of uveal melanoma makes it possible for many patients to retain the affected eye, but a proportion will develop secondary complications such as neovascularisation of the iris (NVI) and require enucleation. Although vascular endothelial growth factor A (VEGF-A) is known to correlate with NVI and can cause NVI in experimental models, this pro-angiogenic cytokine is consistently reported to be absent in uveal melanoma. Novel anti-VEGF therapies are now in clinical trial, and the authors therefore wished to determine whether VEGF-A was indeed elevated in melanoma bearing eyes. METHODS: VEGF-A concentrations were measured in aqueous and vitreous from 19 and 30 enucleated eyes respectively. RESULTS: Elevated VEGF-A concentrations (up to 21.6 ng/ml) were found in melanoma bearing eyes compared with samples from patients undergoing routine cataract extraction (all had values below 0.96 ng/ml). Immunohistochemistry showed VEGF-A protein in the iris and/or ciliary body of 54% and basic fibroblast growth factor (bFGF) in 82% of the eyes examined. VEGF was found to a limited extent and at very low levels in only 9% of these tumours. Aqueous or vitreous VEGF levels showed no apparent correlation with retinal detachment, tumour size, vascularity, or immunohistochemistry. Though limited in number, the highest VEGF levels correlated with previous radiation therapy, and with the presence neovascularisation of the iris or optic nerve head. bFGF was not significantly elevated in ocular fluids: it is known to be a pro-angiogenic agent and was detected in the majority of primary uveal melanomas. CONCLUSION: Based on this study, though the source of VEGF within eyes harbouring uveal melanoma is not clear, these data suggest that anti-VEGF therapy might prove useful in the management of some patients with NVI secondary to uveal melanoma.
UI - 11839674
AU - Naus NC; Verhoeven AC; van Drunen E; Slater R; Mooy CM; Paridaens DA;
TI - Luyten GP; de Klein A Detection of genetic prognostic markers in uveal melanoma biopsies using fluorescence in situ hybridization.
SO - Clin Cancer Res 2002 Feb;8(2):534-9
AD - Department of Ophthalmology, Erasmus University Rotterdam, 3000 DR Rotterdam, the Netherlands.
PURPOSE: In uveal melanoma, specific chromosomal abnormalities are known to correlate with the risk of metastases; changes in chromosomes 3 and 8q correlate strongly with a decreased survival of the patient, whereas chromosome 6 abnormalities are associated with a better prognosis. Usually, karyotyping and fluorescence in situ hybridization (FISH) analysis are used to detect these abnormalities in resected tumor tissues. However, the evaluation of these chromosomal changes is compromised in patients treated with eye-retaining treatment protocols because of the lack of tumor material. The purpose of this study was to validate the use of FISH for the analysis of genetic prognostic markers. EXPERIMENTAL DESIGN: We analyzed 40 uveal melanoma fine needle aspiration biopsies (FNABs) and the corresponding main tumor with FISH. RESULTS: All biopsies were found to contain tumor cells, and FISH analyses of the samples were successful in all cases. Statistical analysis showed very good agreement between the FISH results from the biopsies and those from the main tumor. In only 2 of 249 hybridizations did we find a small variation that could have led to a misclassification. CONCLUSIONS: Our results indicate that the application of FISH to FNABs is a reliable method for assaying genetic prognostic parameters such as chromosome 3 loss and/or chromosome 8q gain. Implementation of this method in a diagnostic setting means that we are able to identify patients at risk of developing metastatic disease, not only in enucleated patients but also in cases treated with conservative treatment modalities such as radiotherapy.
UI - 11886408
AU - Layton C; Glasson W
TI - Clinical aspects of conjunctival melanoma.
SO - Clin Experiment Ophthalmol 2002 Apr;30(2):72-9
AD - University of Queensland Medical School,Herston, Queensland, Australia. firstname.lastname@example.org
Conjunctival melanoma is a rare but important condition encountered in ophthalmology. This paper reviews conjunctival melanoma as a clinical entity, with particular emphasis on differential diagnosis, management and prognostic factors. Relevant references were located through a comprehensive search of articles published between 1980 and early 2001 on Medline, using both the WinSpirs and PubMed platforms. The references of these articles were then checked for further articles of relevance. The condition is uncommon and its presentation variable; therefore, relevant studies were found to suffer from small numbers of subjects. This may be the cause of the confusion that still surrounds the condition and its management.
UI - 10900104
AU - Singh AD; Shields CL; Shields JA; Sato T
TI - Uveal melanoma in young patients.
SO - Arch Ophthalmol 2000 Jul;118(7):918-23
AD - Oncology Service, Wills Eye Hospital, 900 Walnut St, Philadelphia, PA 19107, USA. email@example.com
OBJECTIVE: To study the clinical profile of young patients with uveal melanoma. DESIGN: Retrospective case-control series. SETTING: Tertiary referral center. PATIENTS: Data on 63 patients aged 20 years or younger with uveal melanoma were reviewed for clinical profile and association with oculo(dermal) melanocytosis, familial uveal melanoma, dysplastic nevus syndrome, cutaneous melanoma, and other second malignant neoplasms. RESULTS: Of 8000 patients with uveal melanoma, 63 (0.8%) were found in patients who were 20 years of age or younger. The median age at diagnosis was 16 years, and the youngest patient was 3 years old. Sixty-two patients (98%) were white, and uveal melanoma was unilateral in all cases. Seven patients (11%) had oculo(dermal) melanocytosis. Two patients (3%) had dysplastic nevi syndrome, and personal history of cutaneous melanoma was observed in 1 patient (2%). No other second cancers were present in any patient. The 5- and 15-year posttreatment survival estimates were 0.95 (95% confidence interval, 0.87-1.00) and 0.77 (95% confidence interval, 0.52-1.00), respectively. CONCLUSIONS: Uveal melanoma is rare in children or teenagers. It occurs in a heterogeneous group displaying various associations, especially with oculo(dermal) melanocytosis. Oculo(dermal) melanocytosis is 9 times (95% confidence interval, 3.6-22.8) more common in young patients with uveal melanoma than in the general population with uveal melanoma. Young patients with uveal melanoma have short-term (5-year) survival better than that of adults, but the long-term (15-year) survival is similar to that of adults. Arch Ophthalmol. 2000;118:918-923
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