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

A reappraisal of survival data on patients with uveal melanomas has led us to these impressions: (a) that the mortality rate before enucleation is low, estimated at 1% per year; (b) that the mortality rate rises abruptly following enucleation, reaching a peak of about 8% during the second year after enucleation; and (c) that approximately two-thirds of the fatalities could be attributed to the dissemination of tumour emboli at the time of enucleation. From these impressions we believe the following conclusions are warranted: (a) enucleation as it has been performed in the past may have for many patients an adverse rather than a beneficial effect with respect to the development of metastatic disease from malignant melanoma of the choroid and ciliary body. (b) A long-term follow-up study of untreated patients with melanomas of the choroid and ciliary body is indicated. (c) New techniques for enucleation designed to prevent the dissemination of tumour cells must be developed and tested to enable the ophthalmic surgeon to remove safely the tumour-containing eye that has developed such complications as uncontrollable glaucoma, panophthalmitis, or proptosis from extraocular extension.
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PMID:Does enucleation of the eye containing a malignant melanoma prevent or accelerate the dissemination of tumour cells. 35 89

A 61-year-old woman had unilateral acute angle-closure glaucoma and subsequently underwent a Scheie filtering operation. After a two-week interval, a large choroidal and ciliary body melanoma in the glaucomatous eye was found. No evidence of metastatic disease was found and the eye was enucleated. Histopathologic sections did not show extrascleral extension. Two and one-half years later the patient developed local orbital recurrence of the melanoma and fatal metastatic disease. We hypothesized a possible causal relationship between the filtering surgery and the local and systemic recurrence of the tumor.
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PMID:Recurrent orbital and metastatic melanoma in a patient undergoing previous glaucoma surgery. 45 5

A case of metastatic tapioca melanoma of the iris in a 12-year-old girl is reported. The patient had heterochromia, a red painful eye, and was treated for iritis with secondary glaucoma. In the course of 5 months iris lesions with the clinical appearance of tapioca pudding developed, and biopsy disclosed a melanoma. The eye was immediately enucleated, and pathological examination showed a melanoma with predominantly epithelioid-type cells which had infiltrated the angle, the posterior chamber, and the surgical wounds. Conjunctival extension was noted 10 months after enucleation, and regional lymph node metastases were found 4 months later. Previously reported cases are reviewed and compared with the present case.
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PMID:Metastatic tapioca iris melanoma. 50 89

This paper is based on 21 patients with metastases of the choroid from extraocular tumors, observed over a period of 25 years (1952--1977) at Erlangen University Eye Clinic. Approximately 70% of these relatively rare metastases of the choroid are caused by cancer of the breast. Ophthalmoscopically, they are usually localized to the left of the posterior pole and are yellowish. In about 20% of the cases both eyes are affected. Since breast cancer is the most frequent cause of the primary tumor, women in the 40 to 60 age group are the most common sufferers. On the other hand, it is worth mentioning that in 2 cases the metastases were the first signs of any type of malignancy. Typical is the relatively flat, shell-like growth. In cytological specimens the portion of the retina covering the tumor normally shows no evidence of cystic degenerative change, in contrast to malignant melanoma. In view of the short average life expectancy of about 9 months, therapy should consist in preserving the eye and thus some degree of vision. Radiotherapy, chemotherapy or cytostatic therapy whould be tried. Enucleation is only indicated where there is severe pain, secondary glaucoma, amaurosis or if it is impossible to differentiate from a malignant melanoma.
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PMID:[Tumor metastases of the choroid: clinical picture and histology (author's transl)]. 54 92

A patient with spindle melanoma involving the iris and ciliary body refused enucleation at the time of diagnosis in 1933. The eye developed painful glaucoma 13 years later and was enucleated. Histopathologic examination indicated spread of the tumor intrasclerally and subconjunctivally. The patient is still alive without evidence of metastases, 32 years after enucleation and 45 years after initial diagnosis.
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PMID:Melanocytic tumor of the anterior uvea. 71 26

From 1969-1974 1000 unselected enucleated globes have been examined histopathologically. 277 derive from the University Eye Hospital in Hamburg, 723 from various Eye Hospitals in northern and southern Germany. They originate from 589 men and 408 women, three times the sex was unknown. 86 globes had to be removed from children less than 15 years old. 6 groups of etiologies have been distinguished: trauma (308), histologically confirmed neoplastic disease (281), ocular manifestations of systemic diseases (diabetes mellitus, occlusions of central retinal vessels presumably following generalized vascular disease etc.: 128), "operative ocular disease" (164), primary inflammatory disease (71), miscellaneous (malformations, high myopia, pseudo-glioma and pseudo-melanoma: 48). The etiology "operative ocular disease" consists of 67 primary glaucomas (57 adults, 10 buphthalmus), 41 idiopathic cataracts (7 of these congenital) and 3 primary corneal dystrophies, as well as 53 cases of primary retinal detachment. Among the 281 neoplastic diseases, there are 238 primary intraocular malignant melanomas of the uvea, 18 retinoblastomas, 4 primary reticulumcellsarcomas of the retina, 2 choroidal nevi, 10 intraocular metastases and 9 orbital tumors. 16 enucleations among the 1000 enucleations have been performed for pseudo-gliomas (5 x Coats disease, 5 x persistent primary hyperplastic vitreous, 2 x retrolental fibroplasia, others 4 x). The manifestations of systemic disease are consisting of 68 central retinal vein-occlusions, 30 complications of diabetes mellitus and 10 central retinal artery occlusions as well as 20 other generalized diseases. A primary inflammatory disease led to enucleation 50 times due to an intraocular process, 5 times due to scleritis and 18 times as a consequence of keratitis (including 13 times herpes simplex). As the final clinical cause for enucleation the following categories have been elaborated: secondary glaucomas (416), clinical diagnosis of "tumor" (275), atrophy and phthisis bulbi (118), inflammation (112), acute trauma to 4 weeks after the accident (72), others (7). In conclusion the central role of rubeosis iridis leading to secondary angle closure glaucoma is emphasized. This process presents a challenge to ophthalmologic research. Finally the significance of early surgery for primary angle closure glaucomas and for complete restoration of the anterior chamber after trauma and any intraocular procedure is stressed.
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PMID:[Etiology and final clinical cause for 1000 enucleations. (A clinico-pathologic study) (author's transl)]. 95 59

Of three women and one man with metastatic carcinoma of the iris, the average age of the four was 50.2 years. Two of the tumors originated in the breast and two in the lungs. The average survival from time of diagnosis of the iris lesion was less than six months. Each patient presented with characteristic grayish-white translucent nodules on the iris or in the anterior chamber angle. The patients displayed other features of iris metastases such as secondary glaucoma, rubeosis iridis, iris atrophy, anterior uveitis, hypopyon, and hyphema. As an aid in the clinical evaluation, anterior segment fluorescein angiography was performed, revealing vascular details not seen clinically. Leakage of dye was a constant feature of the angiogram.
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PMID:Metastatic carcinoma of the iris. 119 Feb 88

We describe a case of cutaneous malignant melanoma metastatic to the iris and the angle 31 months after excision of the primary tumor in a 37-year-old caucasian female patient. The patient who had numerous metastases (lung, liver, cerebrum, skin) suffered from secondary glaucoma and died 5 months after the discovery of the intraocular metastases. The glaucoma was treated with medications and cyclocryotherapy. There was no response of the iris metastases to cyclical combined chemotherapy.
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PMID:[Unilateral iris metastasis of cutaneous malignant melanoma]. 129 74

The use and development of iodine-125 plaque therapy for choroidal malignant melanoma are described. Since 1975 experience has led to changes in plaque design and insertion techniques. Twenty-one patients were irradiated with local episcleral iodine-125 plaques. Three patients required a second plaque for tumour recurrence. Four eyes were enucleated because of continued tumour growth and a further eye was removed because of glaucoma secondary to radiation retinopathy. Two patients (9.5%) died of metastases. The remaining 19 patients are alive and clinically clear of metastases, with a mean follow up time of 73.1 months (range 43-142 months).
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PMID:Improved iodine-125 plaque design in the treatment of choroidal malignant melanoma. 173 23

Intraocular melanoma was diagnosed in a 13-year-old horse. Secondary clinical findings included keratitis, cataract, and glaucoma. The eye was enucleated. Follow-up information did not give an indication of metastatic disease.
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PMID:Anterior uveal melanoma, with secondary keratitis, cataract, and glaucoma, in a horse. 174 9


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