Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Lymphoid tumors of the conjunctiva and orbit are rare and remain localized in the majority of cases. Sometimes it is not possible either clinically or histologically to differentiate between a non-Hodgkin's lymphoma (NHL) and benign lymphoid hyperplasia. A series of 24 patients is reported. Nineteen were classified as having malignant NHL and 5 benign hyperplasia; 1 of these 5 later developed metastases, however. All patients had systemic work-up: 18 had Stage I, 1 had Stage II, and 5 had Stage IV disease. All patients received local radiation therapy with doses of 2400 to 2750 rad in 2-3 weeks for lesions of the eyelid and conjunctiva, and between 3000 and 3750 rad in 3-4 weeks for retrobulbar lesions. The lens was shielded in all patients except in 2 who had NHL of the vitreous body. A method of shielding the lens with a lead block mounted on a "low vac lens" is described, and the dose distribution within the eye and orbit is presented. The dose to the ocular lens is reduced to about 10% of the tumor dose with this technique. Patients who were treated with doses higher than 3000 rad experienced conjunctivitis and skin erythema that resolved completely. No other effects of radiation on normal structures of the ocular adnexa were observed in the 20 patients who are alive and without signs of tumor 10-46 months with a median follow-up time of 22 months.
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PMID:Radiation therapy of conjunctival and orbital lymphoid tumors. 643 Aug 46

Seventeen patients with ocular or oculodermal melanocytosis were identified among 1,250 Caucasian patients with uveal malignant melanoma. The uveal melanomas in these seventeen patients were similar in size, cell type, and tendency to metastasize to those occurring in reported populations without ocular or oculodermal melanocytosis. Clinical and histopathologic study of these 17 cases indicated that all of the affected eyes had episcleral and choroidal melanocytosis and that other ocular and periocular tissues (sclera, iris, conjunctiva, angle structures, and optic disc) were involved less commonly. The uveal malignant melanoma that was present in each of these cases involved the eye with melanocytosis. Furthermore, the melanoma arose from the zone of uveal melanocytosis in every eye with sectoral involvement. Statistical analysis of these data supports the contention that uveal malignant melanoma has a higher incidence in white persons with ocular or oculodermal melanocytosis than in those without these conditions.
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PMID:Uveal malignant melanoma associated with ocular and oculodermal melanocytosis. 713 41

The principal malignant melanocytic tumors of interest to ophthalmologists are those originating in the skin of the lids, the conjunctiva, and the uveal tract. Metastasis rarely, if ever, develops from melanocytomas of the optic nerve head, tumors of the pigmented epithelia, or primary melanomas of the orbit. Malignant melanomas of the lids and conjunctiva have many more features in common with those of the skin than with the more prevalent uveal melanomas. The most important of these are the tendency to metastasize via lymphatic channels to the regional lymph nodes and the frequent occurrence of metastatic disease at the time of initial presentation. In general, melanomas of all tissues carry a worse prognosis when they are large and/or thick, they exhibit deep invasion, they are of the epitheloid cell type, mitotic activity is marked, metastatic disease is evident, and the patient is older. Histogenetic classification of uveal melanomas has not been shown to be a useful guide to prognosis of patients with such lesions.
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PMID:Melanocytic tumors of interest to the ophthalmologist. 741 38

One hundred twenty-six surgically excised pigmented lesions of the conjunctiva were evaluated and correlated with clinical data and follow-up information. Of these, 42 were classified as conjunctival melanomas, with 18 arising apparently de novo, 15 from acquired melanosis, and nine from nevi. The six tumor deaths occurred only in patients with melanomas arising de novo or from acquired melanosis, Patients with tumor deaths usually demonstrated local recurrences long before metastases occurred. Moreover, several patients had local recurrences treated repeatedly for years without metastatic spread. Recent clinical findings relating to skin melanomas were applied and evaluated.
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PMID:Mayo Clinic experience with conjunctival melanomas. 741 73

Primary ocular melanomas usually arise in the uvea, in the choroid and ciliary body. They metastasize primarily and initially exclusively, to the liver. Metastasis and survival is determined by the maximum tumour dimension, the number of epithelioid cells present within the tumour, vascular patterns within the tumour and nucleolar size and activity. Ganglioside and integrin profiles differ from cutaneous melanomas. Iris melanocytic lesions tend not to metastasize, most being naevi of varying degrees of aggressiveness which may cause glaucoma and corneal decompensation. Conjunctival melanoma is a rare unilateral tumour arising either in primary acquired melanosis or de novo rather than within a naevus. Survival of the patient depends on the location of the tumour and the histological subtype. Tumours not arising in the bulbar or limbal conjunctiva have a much poorer prognosis as do eyelid (cutaneous) melanomas if they involve the lid margin.
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PMID:Pathology of ocular melanomas. 755 88

Blue nevus is an uncommon pigmented lesion of dermal melanocytes. By convention, two well defined histologic variants, designated as "common" and "cellular", have been recognised. In the last few years, these lesions have attracted much attention due to the recognition of news entities and to its confusion with malignant melanoma. In the present review, we point out the more striking features of new related entities (combined nevus, deep penetrating nevus, compound blue nevus) and establish the differential diagnosis with conflictive lesions such as atypical blue nevus, locally aggressive blue nevus, congenital giant melanocytic nevus with nodular growth and melanocytic dermal tumor of unpredictable outcome. We also review the concept of malignant blue nevus and the significance of lymph node metastases. The blue nevus is an uncommon pigmented lesion consisting of dermal melanocytes that can appear in diverse forms: dendritic, spindle-shaped, oval-shaped, or polyhedral. Although it usually occurs in skin, it has been reported in other locations, such as oral mucosa, sclera, uterine cervix, vagina, prostate, spermatic cord, pulmonary hilus, orbit, conjunctiva, maxillary sinus, breast, and lymph nodes 3,8,42,49. Generally, it occurs in adults as a single, acquired, intensely pigmented lesion, although familial and multiple nevi have been reported 7,39. By convention, there are two well-defined histologic variants, designated as "common" and "cellular", but lesions often manifest intermediate features. In the last few years, blue nevus has attracted much attention due to the recognition of new (clinical and histologic) entities and to its confusion with malignant melanoma.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Blue nevus: classical types and new related entities. A differential diagnostic review. 798 22

Malignant fibrous histiocytomas are common sarcomas of later life. They arise most commonly in the lower extremities and, only rarely, in the head and neck. Fibrous histiocytomas, mostly benign, have been reported in the orbit and conjunctiva, but only three benign lesions have been described in the eyelids. I present a case of malignant fibrous histiocytoma of the eyelid which recurred locally, but has shown no evidence of metastases.
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PMID:Malignant fibrous histiocytoma of the ocular adnexa. 825 73

Two patients with epibulbar malignancies were treated by local excision and brachytherapy with ruthenium-106. One patient showed a large melanoma on the epibulbar conjunctiva, the other patient suffered from a recurrent squamous cell carcinoma at the limbus. After excision of the tumor including lamellar sclerectomy and keratectomy, a ruthenium-106 plaque was sutured to the sclera, and a total dose of 290 and 320 Gy, respectively, was delivered to the tumor bed. No severe radiogenic complications were observed except for a rarefaction of the sclera in the treatment area and a slow cataract increase. After a follow-up period of 50 and 22 months, respectively, both patients do not show any recurrence or metastatic disease.
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PMID:Combined local excision and brachytherapy with ruthenium-106 in the treatment of epibulbar malignancies. 827 79

The clinical, radiologic, and histologic features of 14 cases of orbital melanoma are reviewed. Two cases were presumed to be primary orbital melanomas because no primary pigmented lesion was found in the globe, conjunctiva, or skin. Five cases originated from a conjunctival melanoma, one case from an eyelid cutaneous melanoma, and the remaining six patients had extrascleral extension of a choroidal melanoma. Four patients at the time of first diagnosis already had extraorbital metastases (one patient with extrascleral extension of a choroidal melanoma also had a metastasis to the opposite orbit). The median time interval between diagnosis and metastasis was 14 months. Patients without metastatic disease received radical surgery (partial or total orbital exenteration, in addition to regional lymph node resection if indicated) or conservative treatment (tumor excision plus chemotherapy and interferon). Log-rank test showed an equally poor prognosis for both groups (median time to metastasis was, respectively, 19.5 and 8 months), with no statistically significant difference between the two groups. The authors' reconstructive techniques (dermis-fat grafting and transplantation of temporalis muscle) following partial- and total orbital exenteration are described.
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PMID:Primary and secondary orbital melanomas: a clinical and prognostic study. 854 Dec 58

A 68-year-old man with lung carcinoma and no systemic metastasis presented with a blind, painful right eye. Examination showed no perception of light in the affected eye, elevated intraocular pressure, marked epibulbar hyperemia, and a white placoid mass in the conjunctiva nasally. Although a cataract precluded a clear view of the fundus, ultrasonography disclosed a total retinal detachment and a diffuse thickening of the choroid. Metastatic carcinoma was suspected clinically and the eye was enucleated because of severe, intractable pain. Pathologic examination demonstrated extensively necrotic metastatic adenocarcinoma involving the conjunctiva, peripheral cornea, sclera, iris, ciliary body, choroid, optic nerve, subarachnoid space, and orbit. Metastatic disease usually affects a singular ocular tissue, and it is highly unusual for such widespread ocular involvement to be the first sign of systemic metastasis from a primary neoplasm.
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PMID:Diffuse ocular metastases as an initial sign of metastatic lung cancer. 967 12


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