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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This article reviews the literature published in 1996 regarding conjunctival and corneal tumors. There is an increased incidence of squamous cell carcinoma of the conjunctiva in patients with HIV infection, especially in young individuals and Africans. Presumed causative factors for conjunctival squamous cell carcinoma include ultraviolet light, HIV infection, human papillomavirus and other unknown factors. Metastatic tumors to the conjunctiva appear at an advanced stage of the disease, and metastases to the conjunctiva are a poor prognostic sign for survival. Reviews of premalignant lesions of the conjunctiva, including diagnosis, treatment, and recurrence, are discussed. Spindle cell and mucoepidermoid variants of squamous cell carcinoma of the conjunctiva have a worse prognosis for intraocular extension compared with usual conjunctival squamous cell carcinoma.
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PMID:Tumors of the cornea and conjunctiva. 1017 Apr 45

Orbital melanomas comprise a heterogeneous group of pigmented tumours originating from melanocytes of the ophthalmic tissues, or represent distant metastases of cutaneous melanomas to the orbit. They can be classified into primary and secondary orbital melanomas. Whereas primary orbital melanomas are extremely rare, secondary orbital melanomas are seen more often and usually represent massive extrascleral extensions of uveal melanomas. Their diagnosis is difficult and controversy exists both about the treatment policy and regarding the prognosis. In an effort to clarify some of the aspects of the biological behaviour of these intriguing lesions, we retrospectively reviewed all orbital melanomas treated in our departments during the last eight years. The records of 15 patients with massive secondary orbital melanomas treated surgically were reviewed and analysed. Eleven of the patients were female and four were male. The mean age at the time of surgery was 68 years. Presenting features included unilateral orbital mass, often with painless proptosis, conjuctival bleeding, acute glaucoma crisis, decreased visual acuity and intermittent diplopia. The site of origin was the uveal tract in nine cases, the conjunctiva in three, the eyelids in two and the skin of the lower extremity in one patient. All patients were treated surgically with various types of orbital exenteration. Additional treatment included radiotherapy and chemotherapy. Two patients died from intracranial extension of the disease and 10 died from distant metastases. Three patients are alive with no evidence of disease. The longest survival was 33 months and the mean survival was 16.6 months. Early diagnosis and proper management of ocular melanoma prevents orbital extension and prolongs patient survival. Surgical treatment of secondary orbital melanoma with or without adjuvant radiotherapy and/or chemotherapy does not seem to improve patient survival when compared with conservative treatment used in other reports. However, orbital exenteration is effective for local control of the disease.
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PMID:Secondary orbital melanomas: analysis of 15 cases. 1096 50

Early gastric cancer has an excellent outcome following surgical treatment. In particular, mucosal gastric cancer (m-cancer) very rarely results in metastatic dissemination and may be successfully treated by local surgical resection. We report a 64-year-old Japanese woman who presented with a recurrent cystic lesion on the left bulbar conjunctiva, with a biopsy specimen revealing metastatic signet-ring cell carcinoma. Gastrointestinal investigations revealed an early gastric cancer in the lesser curvature of the stomach. Biopsy specimen of the gastric lesion indicated poorly differentiated adenocarcinoma, which was identical to findings in the lesion in the bulbar conjunctiva. She underwent a distal gastrectomy and made an uneventful recovery. Histopathological analysis indicated a gastric signet-ring cell carcinoma that was limited to the mucosal layer, without evidence of lymphatic spread. Although the exact mechanism of metastatic dissemination to the bulbar conjunctiva is unclear, this case is very unusual, because ocular metastases almost invariably occur in the context of documented and established malignant disease. This is, to our knowledge, the first reported case of a patient with gastric mucosal cancer who presented with a conjunctival metastatic deposit and who subsequently received curative surgical treatment for both conditions.
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PMID:Rare case of early mucosal gastric cancer presenting with metastasis to the bulbar conjunctiva. 1211 86

Sentinel lymph node (SLN) biopsy has emerged as a technique for accurate staging of solid tumors. This technique permits the detection of microscopic metastases in clinically negative regional lymph nodes and may be indicated for malignancies that have a propensity for regional nodal metastasis. With the exception of basal cell carcinoma, almost all malignancies of the eyelid and conjunctiva metastasize to regional lymph nodes as the site of first metastasis. The histologic status of the SLNs has been shown to be the most significant prognostic factor with respect to recurrence and survival in patients with cutaneous melanoma. The indications for and the feasibility of SLN biopsy for eyelid and conjunctival tumors and our experience with this technique are reviewed.
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PMID:Sentinel node biopsy as a tool for accurate staging of eyelid and conjunctival malignancies. 1221 63

Epidermodysplasia verruciformis (EV) is a hereditary disease that has served as a model for viral-induced carcinogenesis. Patients with EV have an increased susceptibility to infection with human papillomavirus, which results in the development of benign lesions in childhood. The lesions may resemble tinea versicolor in appearance and distribution, and usually remain benign. However, later in life cutaneous squamous cell carcinoma may develop on sun-exposed areas, such as the forehead. Radiation therapy may not only result in the malignant conversion of EV lesions, but may also increase the risk of metastases. To our knowledge, this is the first report of a patient with EV in whom squamous cell carcinoma of the conjunctiva developed. His clinical course was complicated by ocular invasion causing blindness, metastasis, and eventually death.
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PMID:Ocular and cutaneous squamous cell carcinoma in an African American man with epidermodysplasia verruciformis resulting in blindness and death. 1457 47

We herein report a case of abnormal arrangement of the pancreato-biliary ductal system (AAPB) followed by advanced gallbladder cancer 9 years after the initial endoscopic retrograde cholangiopancreatography (ERCP) diagnosis and almost 3 years after follow-up ultrasonography (US). A 65-year-old woman was referred to our department from a private clinic because of difficulty in controlling her diabetes mellitus. The patient had no complaints, and physical examination revealed no jaundice in her skin or conjunctiva. ERCP demonstrated the presence of AAPB (bile duct-main type) without congenital dilatation of the bile duct or irregularity in the gallbladder wall. She did not wish to undergo cholecystectomy. Follow-up transabdominal US revealed no change in the gallbladder. Two years and 9 months after this US examination, she developed advanced gallbladder cancer involving the liver and bile duct, with paraaortic lymph node metastases confirmed by US, computed tomography, and ERCP. This case re-emphasizes the necessity for patients with AAPB to undergo intensive follow-up examinations or cholecystectomy when the diagnosis of AAPB has been established.
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PMID:Abnormal arrangement of the pancreato-biliary ductal system associated with advanced gallbladder cancer diagnosed 3 years after follow-up ultrasonography. 1467 31

A neonate with stage IV bilateral adrenal neuroblastoma associated with metastases to the skin, liver, bone marrow, and right ocular conjunctiva is reported. At birth, skin metastases were present all over the body. He underwent a combination of chemotherapy, surgery, and peripheral blood stem cell transplantation (PBSCT). Histopathology was unfavorable with diploid tumor cell DNA content and low levels of TRK-A mRNA expression. Skin and conjunctival metastases disappeared after PBSCT, and there have been no signs of recurrence after 5 years of follow-up. Accurate staging of disease and histologic examination followed by intensive management are essential even in infants with neuroblastoma to ensure successful outcome.
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PMID:A rare case of bilateral stage IV adrenal neuroblastoma with multiple skin metastases in a neonate: diagnosis, management, and outcome. 1561 28

Authors report the cases of 2 patients who had an ocular lesion as the first sign leading to diagnosis of renal cell carcinoma, an uncommon presentation of this neoplasm. The first patient was a 59-year-old man presented with a mass in the right eye. The histological and immunohistochemical profile of the biopsy showed a probable renal cell carcinoma. A CT scan showed a solid mass in the left kidney. The patient underwent radical nephrectomy and excision of the ocular lesion and had an uneventful evolution. The second patient was a 72-year-old man presenting with an ulcerated lesion on the right inferior tarsal conjunctiva. An excisional biopsy of the lesion showed histological and immunohistochemical patterns of a clear cell carcinoma. Abdominal tomography disclosed a right peripheral renal tumor. A right radical nephrectomy was performed. Renal cell carcinoma may present atypically with metastases to quite uncommon organs. Nephrectomy may be of value in selected cases; the ocular metastases are usually excised for aesthetic and functional reasons.
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PMID:Ocular metastasis as first presentation of renal cell carcinoma: report of 2 cases. 1583 85

The conjunctival nevus is one of the most common benign tumors of the ocular surface. Melanomas are rare; they can arise without a preexisting conjunctival nevus, or due to malignant transformation in case of PAM (primary acquired melanosis). The retrospective study analyzed 70 patients with pigmented lesion of the conjunctiva in period 1996-2006 at the Department of Ophthalmology, Faculty of Medicine, Comenius University, Bratislava, with the aim to determine the frequency of change in size and pigmentation of these benign lesions. Epibulbar pigmented lesions are rare, recognition of their precursors lesions at an early stage is important. Surgical excision is usually effective in eradicating these lesions. Extensive cases of flat primary acquired melanosis with atypia may be managed with mitomycin C. Multifocal and advanced melanoma, especially showing intraocular or orbital invasion, may require exenteration and/or radiotherapy to adequately extirpate the neoplasm locally. However, systemic metastases might have already develop in patients with advanced stage of disease (Fig. 7, Ref 13). Full Text (Free, PDF) www.bmj.sk.
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PMID:Conjunctival nevus and melanoma. 1797 44

A 56-year-old man had a 6-month history of a progressively enlarging mass of his right upper eyelid. Thirty-six years previously he had undergone thyroidectomy for medullary thyroid carcinoma in the absence of family history. Supraclavicular lymph node metastases were discovered 3 years after initial diagnosis, pulmonary metastasis 26 years later, and cervical lymph node metastases 35 years later. Ocular examination revealed a pedunculated, amelanotic, highly vascularized metastasis involving the right upper eyelid and palpebral conjunctiva. Ophthalmoscopy revealed 2 amelanotic, dome-shaped choroidal metastases in the right eye and 3 similar tumors in the left eye. Medullary thyroid carcinoma not associated with the multiple endocrine neoplasia syndromes can metastasize to the ocular region and metastases can occur decades after the original diagnosis.
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PMID:Simultaneous eyelid and choroidal metastases 36 years after diagnosis of medullary thyroid carcinoma. 1880 81


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