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)

Clinical identification of tapioca melanoma of the iris is important because its medical treatment may differ from that of other malignant iris melanomas. The characteristic iris nodules must be differentiated from granulomatous uveitis, metastases, and Lisch nodules (neurofibromatosis). We will discuss the anterior segment findings, secondary glaucoma, and fluorescein iris angiographic and histopathologic data from two patients, one with a single nodular type and one with a seeding type of tapioca melanoma of the iris.
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PMID:Tapioca melanoma of the iris. 851 92

Fourteen patients with posterior uveal melanomas were treated using single fraction stereotactic radiosurgery. In each case a dose of 70 Gy was administered to the periphery of the tumour. Regression of the tumour has been observed in 13 patients, whilst the lesion has remained unchanged in one patient. The visual acuity has deteriorated in all 14 patients. Significant radiation induced adverse reactions were noted in 13 patients and include; retinopathy, optic neuropathy, rubeosis iridis, and secondary glaucoma. Two patients have required enucleation because of intractable rubeotic glaucoma. One patient has died from proven metastases. Although stereotactic radiosurgery appears to be a practical and effective method of treating uveal melanomas, its usefulness is limited by a high incidence of radiation induced adverse reactions. Further work is required to refine the current treatment protocol and establish an optimal prescription dose.
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PMID:The use of single fraction Leksell stereotactic radiosurgery in the treatment of uveal melanoma. 901 41

Metastasis is the most common ocular malignancy. An atypical clinical presentation whoever, can delay the diagnosis, particularly when there is no history of malignant disease. Our patient initially presented with a painful red eye and a subretinal mass, but without signs of intraocular inflammation or glaucoma. The results of the diagnostic work-up were inconclusive. Postmortem histopathologic examination revealed a metastasis to the posterior choroid.
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PMID:Choroidal metastasis presenting as a painful red eye: clinicopathologic report. 947 15

Twenty patients with malignant uveal melanoma were treated at the The Svedbergh cyclotron in Uppsala from 1989 to 1991. Each tumour received a total dose of 54.6 Gy in four equal fractions on four following days. After treatment the melanoma in all eyes showed decrease in size combined with irradiation retinopathy. In eight patients the treatment was successful after five years. Nine eyes had to be enucleated, two due to recurrence and seven due to neovascular glaucoma. Three patients died, two from metastases and one from heart disease. In all patients the visual acuity was dependent on the distance between the irradiation field and the macula or optic nerve. Each patient suffered from transient post irradiation skin erythema and permanent loss of eyelashes and eyebrows when these were included in the irradiation field. The development of secondary glaucoma was positively correlated with tumour volume, but not to the age or sex of the patients. Histological examination of all the enucleated eyes revealed residual viable tumour without obvious radiation damage: mitotic figures were not identified. MRI examination, performed before and after treatment, demonstrated a marked shift in water binding properties after irradiation. The final visual acuity was dependent on the location of the tumour.
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PMID:Proton irradiation of malignant uveal melanoma. A five year follow-up of patients treated in Uppsala, Sweden. 1005 9

Transsphenoidal encephalocele is associated with tongue-shaped retinochoroidal coloboma and optic disc dysplasia. Non-Graves' orbital polymyositis is associated with giant cell myocarditis. Ocular embolic disease can result from papillary fibroelastoma of the heart. Cutaneous melanoma can metastasize to the eye in the form of intraocular pigment without a discrete mass leading to heterochromia, glaucoma, and visual loss. Patients with atopic dermatitis are prone to develop retinal detachment similar in configuration to traumatic retinal detachment. The retinal hamartomas in tuberous sclerosis are usually stable, but occasionally the hamartomas show new or increased calcification, and rarely new lesions appear de novo.
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PMID:Ocular manifestations of various systemic diseases. 1016 Apr 13

The management of uveal metastasis is focused on both the patient's systemic condition and the ocular condition. If there is evidence of systemic metastatic disease, then treatment of the nonocular and ocular metastatic tumors consists of chemotherapy, hormone therapy, immunotherapy, multiple-site radiotherapy, or observation. If there is no evidence of systemic involvement, then whole-eye treatment with chemotherapy, hormone therapy, immunotherapy, radiotherapy, or, rarely, enucleation is considered. For solitary uveal metastases, plaque radiotherapy is offered, and if the tumor is small, laser photocoagulation, resection, or thermotherapy can be used. Inactive uveal metastases are managed by periodic observation, but active uveal metastases often produce visual loss, secondary glaucoma, and pain, therefore, treatment is usually indicated. Radiotherapy is quite effective for control of most uveal metastasis. The technique of external beam radiotherapy is most often used and is delivered over a 3- to 4-week period in an outpatient setting. For those patients who fail chemotherapy, hormone therapy, immunotherapy, or external beam radiotherapy or those patients with a solitary uveal metastasis, plaque radiotherapy is an alternative method. Plaque radiotherapy is focal radiotherapy delivered to the eye in an inpatient setting over a relatively short period of approximately 3 days. Plaque radiotherapy provides satisfactory tumor control, even in eyes that fail other treatments. Side effects from plaque radiotherapy are comparable to those from external beam radiotherapy. Importantly, the plaque treatment requires less of a time commitment for these patients with a limited life expectancy.
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PMID:Plaque radiotherapy for the management of uveal metastasis. 1018 97

Cutaneous malignant melanoma metastatic to the eye is rare but has been documented. The usual presentation is after the diagnosis of disseminated metastases. A 40-year-old Caucasian man presented with floaters and hazy vision due to ocular metastasis. He developed painful intractable rubeotic glaucoma leading to enucleation. Histopathological examination confirmed anterior segment tumour adherent to the iris that was consistent histopathologically with the primary cutaneous melanoma.
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PMID:Intraocular metastases of cutaneous malignant melanoma: a case report and review of the literature. 1045 Mar 91

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

Breast carcinoma is the most common primary tumor producing intraocular metastasis. Metastases to the iris and ciliary body are relatively rare. The authors report a case of a 61-year-old lady, operated for carcinoma of the left breast 3 years back, who presented with symptoms and signs of acute narrow-angle glaucoma in the right eye. A diffuse whitish plaque-like mass in the upper nasal quadrant of the iris with an episcleral nodule on the limbus in the corresponding area and all the signs of acute narrow-angle glaucoma were present in the right eye. Intraocular pressure was controlled medically. Fine-needle aspiration cytology from the episcleral nodule showed malignant cells. Histopathology of the excised nodule showed metastatic poorly differentiated carcinoma, and the cellular pattern was similar to the carcinoma of the breast. There was no other metastasis anywhere in the body. Fine-needle aspiration cytology from an external lesion of the eye is a less invasive and easier procedure than paracentesis to diagnose the metastatic nature of the lesions. The rare features in our case are the clinical presentation as acute glaucoma and the ocular structures being the first and only site of metastasis.
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PMID:Anterior uveal and episcleral metastases from carcinoma of the breast. 1096 54

Neoplasia can affect all ocular tissues. The clinical appearance of ocular neoplasia can vary considerably depending on the specific tissue involved. Intraocular neoplasia may mimic or incite ocular inflammatory disease in addition to causing hyphema or secondary glaucoma. Intraocular neoplasms can be primary tumors or may be secondary to metastatic disease or systemic neoplasia. Primary neoplasms, metastatic tumors, tumors extending from adjacent structures, and systemic neoplasms can also affect the adnexal tissues. Many ophthalmic tumors are histologically benign but are locally invasive and, within the confined space of the eye or orbit, can produce significant tissue distortion. Certain ocular neoplasms, such as many canine eyelid tumors, are amenable to simple excision and can be adequately managed in general practice. The evaluation and treatment of other ophthalmic neoplasms, however, may require the additional equipment available only in larger specialty practices, such as computed tomography and radiation therapy. Early diagnosis of ocular neoplasia is an important aspect of successful management.
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PMID:Ocular oncology. 1137 32


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