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

Primary ocular melanocytic neoplasms from 91 dogs were divided into two groups by histologic criteria. Seventy-five were benign and composed of spindle-shaped and large polyhedral melanocytes similar to those of human ocular melanocytomas. Fifty-nine of these originated in the uvea where most resulted in uveitis, glaucoma, or hyphema prior to enucleation. None metastasized. Nineteen melanocytomas were limbal tumors. None metastasized, but three of nine incompletely excised tumors were found within the anterior chamber 2 to 3 years after the initial removal. Sixteen uveal melanocytic neoplasms were histologically malignant. Three had confirmed metastases, all within 3 months of enucleation. Cell type or pattern of growth within the globe were not predictive of biologic behavior. Our data suggest that the mitotic index is the best criterion for histologic identification of ocular melanomas with high metastatic potential. We propose that the classification of primary ocular melanomas be simplified to include only two categories: melanocytoma (benign) and melanoma (potentially malignant). Further behavioral data may justify a grading scheme for melanomas based upon mitotic index.
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PMID:Morphology and behavior of primary ocular melanomas in 91 dogs. 375 Jul 35

Twenty-three patients were treated with radon therapy for choroidal melanoma at the Ohio State University Hospitals, Columbus, between 1968 and 1976. We present an 18-year experience, including follow-up of at least eight years, in all those receiving therapy. Three patients (13%) died of metastatic disease. Four patients (17.4%) died of other causes. Sixteen patients (69.6%) were alive, with no signs of metastatic disease. Eight patients subsequently required enucleation due to inadequate tumor response. Of the 15 patients who demonstrated successful tumor destruction and retained their eyes, 13 (86.7%) developed substantial irradiation-induced retinopathy, including hard exudates, telangiectasias, neovascularization, microaneurysms, intraretinal and vitreous hemorrhages, secondary glaucoma, and irradiation-induced cataract. Our long-term results indicate a high incidence of both vascular complications and decreased visual acuity.
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PMID:Radiotherapy for choroidal melanoma. An 18-year experience with radon. 382 11

A 46-year-old woman with a history of breast carcinoma and no known metastatic disease presented with iridocyclitis and secondary glaucoma. Intraocular inflammation and pressure elevation persisted despite standard medical therapy, and paracentesis was performed. Cytological examination of the aspirate revealed adenocarcinoma. Subsequent studies disclosed no evidence of extraocular metastasis. Two courses of radiation therapy to the involved eye resulted in a dramatic reduction in intraocular inflammation and allowed temporary control of the intraocular pressure. Ultimately, however, progressive glaucoma necessitated enucleation. This case confirms previous statements that iridocyclitis may be the initial clinical manifestation of metastatic malignancy. In addition, this report emphasises the importance of paracentesis in the diagnostic evaluation of selected cases of anterior uveitis of unknown aetiology.
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PMID:Metastatic carcinoma of the iris simulating iridocyclitis. 653 95

Helium ion irradiation is a promising alternative therapy for choroidal melanoma. In short-term follow-up (less than 5 years), more than 90% (18/19) of treated patients demonstrated tumor regression. We had to enucleate five eyes after helium ion therapy either because of continued tumor growth (four patients) or other complications (one patient). Two melanomas continued to grow and seemed to be radioresistant. In two other tumors it retrospectively seemed that the entire lesion was not inside the radiation field. In one patient total retinal detachment and glaucoma developed; enucleation was performed because of a painful eye. Metastatic disease developed in no patients. The treatment failures emphasize that there are a number of unresolved issues regarding the use of charged-particle irradiation in the treatment of melanoma. Further studies must be performed to answer these questions and better delineate the use of these newer forms of therapy.
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PMID:Failure of choroidal melanoma to respond to helium ion therapy. 682 68

A newly developed choroidal tumor was observed by an ophthalmologist in 1946. Clinically, it was obviously a malignant melanoma and showed signs of growth. The patient, a 57 year-old woman, refused enucleation because her vision was good. She was examined at intervals by her ophthalmologist. Ten years later the tumor had attained a prominence of 18 D and shortly afterwards the patient developed visual disturbances. Another 11 years later vitreous opacities occurred. After a further 5 years the patient presented with glaucoma which led to chronic corneal edema. The eye was finally enucleated in 1977. Now, four years later, the patient is still well and without any sign of metastases. Histopathologic examination revealed a melanoma of spindle-cell type A, measuring 16 X 16 X 16 mm. The tumor had infiltrated the proximal optic fascicle and the overlying retina. As most prognostic data are based on histopathologic findings it seems essential for the future to find out more about the untreated melanomas (growth rate, vascularization, secondary changes such as perifocal inflammatory reactions, lesions of the retinal pigment epithelium barrier, retinal detachment, cyclitis and glaucoma).
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PMID:[Clinical course of a choroidal melanoma observed for over 30 years]. 685 38

Five-year survival data were available in 78 cases originally classified as uveal melanomas in patients less than 20 years old. Forty-two were malignant melanomas arising from the choroid and/or ciliary body; 13 patients from this group died of metastatic disease. Factors that significantly correlated with fatality were a red, painful eye, extraocular extension at enucleation, basal tumor diameter greater than 10 mm, increased mitotic activity, and tumor necrosis. There were 36 iridic tumors; nine were reclassified as nevi. Of the 27 patients with iridic melanomas, only four died of metastases. The predominant factors relating to fatal outcome were glaucoma, extension of tumor into the ciliary body, diffuse growth, deep angle invasion, scleral invasion by tumor cells, and increased mitotic activity. Except for their relative rarity, uveal melanomas in children and adolescents did not differ significantly from their counter-parts in adults.
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PMID:Uveal melanoma in children and adolescents. 730 10

A study of 11 consecutive patients with anterior uveal melanomas from one institution demonstrated the wide variation in the clinical and histopathologic manifestations of the tumors. The intraocular pressure in the involved eye compared with the fellow eye was elevated in five cases, equal in four, and reduced in two. Histologic studies suggest that the anterior uveal melanomas influence intraocular pressure through their effect on the balance between aqueous production and outflow. Three of the four patients with ciliary body melanomas and glaucoma died of metastatic disease within 3 years of enucleation.
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PMID:Anterior uveal melanomas and intraocular pressure. 741 39

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

An 80-year-old white female developed clinical signs of a large choroidal malignant melanoma in her left eye. There were no signs of metastatic disease, but an asymptomatic chronic lymphatic leukemia was discovered. Histopathologic examination of the enucleated left eye showed a mostly necrotic malignant melanoma of the choroid with areas of spindle B cell differentiation, episcleral extension and secondary angle-closure glaucoma with necrosis of the anterior segment of the eye. On the basis of immunocytochemical studies of the lymphocytic infiltrates in the iridal blood vessels, retinal blood vessels and the choroid, the leukemic disease was classified as B cell lymphoma of low malignancy (lymphoplasmacytoid immunocytoma). A reactive T lymphocytic infiltration of the conjunctival stroma was also noted. Patients with malignant melanomas of the uvea require exclusion of a second malignancy.
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PMID:Necrotic malignant melanoma of the choroid and concurrent intraocular manifestation of malignant non-Hodgkin's B cell lymphoma. 818 27

Ten cases of choroidal melanoma were treated with Argon and/or Krypton laser photocoagulation in this retrospective study. Each patient received an average of 9.6 laser treatment sessions. Three female and seven male patients were treated and followed for an average of 69.9 months. Clinical regression was observed in seven cases (70%). Tumour size in these successfully treated cases ranged from 4.5 x 5.0 x 1.5 mm to 7.0 x 7.0 x 3.5 mm. Continued growth occurred in one case (10%), tumour recurrence which failed to respond to additional laser treatment in another (10%), and although a recurrence appeared to respond to additional laser in a third case (the largest tumour in the series 11.0 x 9.0 x 2.5 mm) extraocular extension was found at enucleation (10%). Complications of laser treatment included cystoid macular oedema (Case 5), branch retinal vein occlusion (Cases 3 and 6), vitreous haemorrhage from neovascularisation at the edge of the scar, optic atrophy and thrombotic glaucoma (Case 8), and macular involvement by laser (Cases 4, 7 and 10). All patients remain alive without any clinical evidence of metastatic disease at the end of the follow-up period. These results suggest that laser photocoagulation treatment is a useful option in the management of small choroidal melanomas. It avoids the psychological trauma of enucleation, and maintains some vision, without compromising life expectancy.
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PMID:Laser photocoagulation treatment of choroidal melanoma. 803 23


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