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)

An emaciated alcoholic 52-year-old white woman presented with an old left corneal perforation and bilateral conjunctival and corneal xerosis. The serum vitamin A level was 0 mumol/L. Laboratory and radiologic findings were consistent with the diagnosis of a fat malabsorptive syndrome secondary to chronic alcoholic pancreatitis. Histopathologic evaluation of her enucleated globe revealed conjunctival epidermidalization, corneal perforation with prolapse and loss of intraocular contents, retinal detachment, and massive choroidal hemorrhage. A second patient presented with bilateral conjunctival xerosis, corneal ulcers, and a low serum vitamin A level. Corneal perforation of one ulcer ensued during her hospitalization. Medical investigation revealed hepatic metastases of an unknown primary source. Causes of vitamin A deficiency and its ocular complications as well as medical and surgical management options are discussed.
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PMID:Corneal perforation in patients with vitamin A deficiency in the United States. 231 Mar 32

A total of 161 cases of choroidal metastases are reviewed. Breast or bronchial carcinomas are the most frequent primary tumors. One-third of the patients develop bilateral choroidal metastases. In 67% of all cases metastatic choroidal lesions were found in the posterior pole. Eighty-nine percent of all patients had a history of malignant tumor, in 11% of all patients choroidal metastasis was the first sign of a primary carcinoma elsewhere in the body. Sixty percent of all patients with choroidal metastases had additional other distant metastases at the time of diagnosis of choroidal involvement. The survival rate is poor: 50% of all patients with choroidal metastasis had died 1 year later. In 35% of all patients, choroidal metastases occurred despite prior systemic therapy with cytotoxic drugs or hormone therapy. In many cases the spontaneously course leads to irreversible loss of central visual acuity due to tumor growth, tumor necrosis or the complications of an exudative retinal detachment. Early fractionated external beam in radiation may prevent this outcome. The clinical course in 71 eyes following irradiation is reported. In 80% radiation therapy led to regression or eradication of the tumor, and a vision of at least 0.4 was maintained in 61% of the treated eyes.
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PMID:[Metastases of malignant extra-ocular tumors to the choroid. Diagnosis and fractionated radiotherapy]. 232

With binocular indirect ophthalmoscopy, fluorescin angiography and ultrasonography 68 choroidal metastases in 52 eyes of 39 patients were diagnosed. The primary tumors were mainly breast cancer (81%) and lung cancer (10%). After radiation treatment the visual acuity improved in 17 eyes (38%), stabilized in 15 eyes (33%), whereas in 13 eyes (29%) deterioration could not be prevented (seven eyes unknown). Regression of the lesions or its accompanying secondary retinal detachment was seen in 78% of the eyes treated. Acute transient side effects of radiation therapy were kerato-conjunctivitis (nine patients) and acute glaucoma in one patient. No cataractous changes of the lens were observed in the post radiation period (one to 42 months). Irradiation of choroidal metastases can contribute to improvement of the quality of life with a treatment scheme of 30 Gy in ten daily fractions.
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PMID:Radiotherapy of choroidal metastases. 249 71

The electro-oculogram (EOG) in the 64 patients with a melanoma of the choroid or ciliary body was compared to the EOG in 11 patients with choroidal metastasis, 11 patients with choroidal naevi and 27 patients with a rhegmatogenous retinal detachment. Using the Dt and the Lp/Dt-ratio, 87.5% of the melanomas could be diagnosed correctly whereas choroidal naevus and retinal detachment were diagnosed correctly in 72.7% and 70.4% of the cases respectively. Choroidal metastases never were classified correctly. Accompanying retinal detachment, tumour volume or a break through Bruch's membrane had no influence on the EOG in the melanoma patients. An important advantage of the method is that it can be used irrespective of the condition of the other eye. Combined with ophthalmoscopy, ultrasonography and fluorescein-angiography the EOG can be an additional aid in the differential diagnosis of malignant melanoma of the choroid and ciliary body.
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PMID:The electro-oculogram as an aid in the diagnosis of uveal melanoma. 262 78

Sixty-seven ocular tumors were studied with magnetic resonance (MR) imaging and computed tomography (CT). These tumors included primary uveal melanoma (n = 55), circumscribed choroidal hemangioma (n = 3), diffuse choroidal hemangioma (n = 1), retinal capillary hemangioma (n = 1), medulloepithelioma (n = 1), choroidal nevus (n = 1), retinoblastoma (n = 1), and choroidal metastases (n = 4). MR imaging demonstrated all these lesions, while CT demonstrated 88%. Associated retinal detachment was more easily distinguished from the neoplasms with MR imaging. Extrascleral extension of melanoma and hemorrhagic cystic necrosis within the melanoma were clearly demonstrated with MR imaging, but not with CT. Ninety-three percent of melanomas were markedly hyperintense, compared with the intensity of the vitreous body, on T1-weighted images and hypointense on T2-weighted images. All metastatic lesions were isointense on T1-weighted images and hypointense on T2-weighted images. The circumscribed choroidal hemangiomas were hyperintense on T1-weighted images and isointense on T2-weighted images. MR imaging is superior to CT in detection of intraocular tumors and may be more specific in diagnosis.
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PMID:Intraocular tumors: evaluation with MR imaging. 340 7

The mode of presentation of ciliary body tumours, their investigation and management are described. The results in 60 such tumours treated by local excision over a 16 year period are reported. The mean follow-up in these cases is 34 months (median: 14 months, range: 1 to 196 months). The eyes were preserved in 47 patients (78 per cent). In these cases the vision was Counting Fingers or better in 34 (72 per cent) and 6/18 or better in 15 (32 per cent). The most serious complications were vitreous haemorrhage (40 per cent), retinal detachment (26 per cent) and residual tumour (20 per cent). Nine patients (15 per cent) have developed metastatic disease.
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PMID:Ciliary body tumours and their management. 346 1

Twenty-two patients, who were suspected of an intraocular tumour, were examined with the high resolution thin slice CT-scan (1.5 or 3 mm slices). The final diagnosis in 14 cases was an uveal melanoma, and in 3 cases in which an uveal melanoma was suspected a chorioretinal haemorrhage, an exudative macular degeneration type Junius Kuhnt and an intrascleral foreign body were respectively found. In 2 cases intraocular metastases were demonstrated, and in 2 other cases malignant lymphomata. One patient had a haemangioma. In 10 of the 14 patients with uveal melanomata enucleation was performed and 4 were treated by ruthenium application. The CT-scan was compared with ultrasonographic, operative and histological findings. From the study it appears that the CT-scan is useful for screening uveal melanomas. It is however difficult to distinguish the uveal melanoma from a secondary retinal detachment; differentiation from an exudative macular degeneration was not possible. The size of the tumour was only represented correctly on the CT-scan in half the cases. CT examination fails to demonstrate or exclude epi- and extrascleral growth. The multiple metastases and the haemangioma could only be seen with difficulty on the CT-scan; the latter was however clearly visible after the injection of contrast. The foreign body could be clearly seen without contrast.
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PMID:CT-scan and intraocular tumours: detection and assessment of size and extrascleral growth of uveal melanomas. 351 18

The predictive value of prognostic factors is of utmost importance for the treatment of patients with retinoblastoma. Functional results, that may be expected following sight saving therapy, can be deducted from ophthalmoscopic findings. Large tumors, tumors located centrally, the presence of extensive retinal detachment or diffuse vitreous seeding are poor prognostic signs. Histopathologic findings of the enucleated eye harbouring retinoblastoma correlate well with the incidence of metastatic disease. Patients in which the tumor has invaded the choroid, optic nerve or sclera have a high risk of developing metastases.
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PMID:[Value of ophthalmoscopy and histology for the prognosis of patients with retinoblastoma]. 362 21

A case of pigmented choroidal lesion coincident with rhegmatogenous retinal detachment was observed. The patient refused enucleation, and the retinal detachment was successfully treated by diathermy without drainage of subretinal fluid. Clinically the lesion was observed to enlarge, and upon enucleation five years after diathermy the tumor was seen to be a spindle-cell choroidal melanoma. The patient died from metastases of melanoma six years after the enucleation.
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PMID:Choroidal melanoma associated with rhegmatogenous retinal detachment. 672 3

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


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