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)

Although metastatic cancer to the uvea is reported to be the most common intraocular malignancy, most ophthalmologists have had little experience with its diagnosis and treatment. This report describes our experience with the diagnosis and management of 70 patients with metastatic cancer to the uvea. Many patients were evaluated with modern diagnostic modalities such as fluorescein angiography, ultrasonography, and the 32P test when indicated. Thirty-one percent of patients had no history of previous malignancy, and the ocular complaints represented the first symptoms of systemic cancer. The ocular malignancy often simulated better-known ophthalmic entities, and the referring diagnosis was correct in only 38% of cases. This series, therefore, reflects the clinical problem confronting the practicing ophthalmologist. About one-half of the patients were treated with external beam irradiation to the involved eye(s), which often resulted in dramatic resolution of the tumor and visual return. Other patients had either no treatment, chemotherapy, or enucleation in selected instances.
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PMID:Diagnosis and management of cancer metastatic to the uvea: a study of 70 cases. 23 66

Plasma carcinoembryonic antigen (CEA) and gamma glutamyl transpeptidase (GTP) were studied in 24 patients with cancer metastatic to the uveal tract. Eighty-three percent demonstrated elevated CEA levels, while only 36% (49 of 135 patients) with primary uveal melanoma showed elevated levels. While none of the uveal melanoma patients had a CEA value greater than 10 ng/ml, 58% (14) of the patients with metastatic tumors to the uvea had values greater than 10 ng/ml. Forty-six percent (11) of patients with metastatic tumors to the uvea demonstrated elevated GTP levels that correlated with documentation of liver metastases. Ninety-two percent of the patients with metastatic cancer to the uvea had either an elevated CEA or GTP level. When used together, plasma CEA and GTP levels appear to be helpful in differentiating metastatic tumors to the uvea from primary uveal melanomas. These assays also appear to be useful in determining tumor burden and concurrent hepatic involvement in patients with metastatic tumors to the uvea.
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PMID:Evaluation of metastatic cancer to the eye. Carcinoembryonic antigen and gamma glutamyl transpeptidase. 84 92

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

Plasma carcinoembryonic antigen (CEA) was studied in 60 patients with histologically confirmed intraocular neoplasms including 56 malignant melanomas of the uvea and four metastatic tumors to the choroid. While 45% of the patients with primary uveal melanomas, as well as 75% of the patients with metastatic disease demonstrated elevated plasma CEA levels, both patients who exhibited metastatic lesions of entodermal origin demonstrated plasma CEA values that clearly fell into a separate, highly elevated category, consistent with metastatic disease or pancreatic or colorectal carcinoma. Thus, in the patient seen with a nonpigmented choroidal mass that may represent either a choroidal hemangioma, amelanotic melanoma, or metastatic tumor, plasma CEA levels may be useful in the differential diagnosis. If the clinician suspects a metastatic tumor from an occult primary site, highly elevated CEA levels may indicate that the lesion is of entodermal origin.
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PMID:Carcinoembryonic antigen. Its role in the evaluation of intraocular malignant tumors. 126 24

A histopathological study was conducted on four cases in which a diffuse iris melanoma presented with glaucoma. Drainage surgery was performed on three eyes for medically non-responsive raised intraocular pressure, and all cases eventually (within 2-7 years) required enucleation for secondary glaucoma. In the iridectomy specimens the tumour melanocytes were small, uniform in size and spindle shaped, while in the enucleation specimens the tumour cells were epitheliod and pleomorphic. The dedifferentiated tumour in the enucleated eyes spread extensively within the anterior chamber and anterior uvea. In three cases there was evidence of intrascleral spread. However, none of the patients has died from metastatic disease in the follow-up period of 2-6 years since enucleation.
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PMID:Dedifferentiation potential of iris melanomas. 179 85

A review of 3706 consecutive patients with uveal melanoma revealed that 40 patients (1.1%) were age 20 years or younger at the time of diagnosis. The youngest patient was age 6 years but the majority of patients (78%) were between 15 and 20 years old. The tumor occurred in the iris in 5 cases (12%) and in the posterior uvea in 35 cases (88%). The mean largest tumor dimension and thickness was 10 mm and 5 mm, respectively. In all cases, the diagnosis of uveal melanoma was suspected before referral, and misdirected treatment was avoided. The tumor was initially treated by enucleation in 24 cases (60%), local resection in 7 (18%), plaque radiotherapy in 3 (8%), and observation in 6 (15%). Secondary treatment was required in 7 cases in the form of enucleation (4 cases), ablative laser (1 case), plaque radiotherapy (1 case), and exenteration (1 case). The mean follow-up period was 68 months (median, 48 months) from the time of treatment, and only one patient died of metastases (from a massive ciliochoroidal melanoma 33 months after treatment). The remainder of the group of young patients are alive and healthy. Cumulative survival rates show that 96% of young patients with uveal melanoma survive at the 5-year period.
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PMID:Uveal melanoma in teenagers and children. A report of 40 cases. 180 Sep 26

Three patients with histopathologically proven orbital metastatic lesions from a carcinoid tumor are reported. Computed tomography (CT) disclosed a well-circumscribed orbital mass in two of three cases. Each tumor was studied by both light and electron microscopy as well as immunohistochemistry and DNA flow cytometry. A review of the literature discloses the relatively rare occurrence of carcinoid tumors metastasizing to the eye and orbit. With the exception of one case, the reported metastatic carcinoid tumors to the uvea all developed from primary bronchial carcinoids. In contrast, the vast majority of the reported orbital metastases arose from ileal carcinoids. Immunohistochemical markers such as chromogranin A, synaptophysin, and serotonin have proven to be useful diagnostic tools in evaluating carcinoid tumors. Furthermore, DNA flow cytometry may be of prognostic value in patients with metastatic carcinoid tumor.
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PMID:A clinicopathologic study of three carcinoid tumors metastatic to the orbit. Immunohistochemical, ultrastructural, and DNA flow cytometric studies. 210 98

Between 1985 and 1989, four patients with uvea metastases of breast cancers were treated in the Dept. of Gynaecology and Obstetrics of the University of the Saar, Medical School, in Homburg/Saar. One of these patients developed binocular metastases. The patient's age at the primary diagnosis of breast cancer was 48 years (median), the others were in pre- or peri-menopausal status. Uvea metastases appeared in median five years after primary diagnosis, always in coincidence with at least one more metastasis of different localisation. All cases with uvea metastases have been treated by radiation therapy with 40 gy reference dose. In three out of five cases, complete remission of the visus restriction could be achieved. In a further case, a temporary partial remission occurred. Two relapses were observed after remission induction, one and four years after treatment respectively.
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PMID:[Choroid metastases in metastatic breast cancer--a rare metastatic site]. 228 23

The left eye of an otherwise healthy child was enucleated at the age of 2 months because of an enlarging mass involving the temporal iris, ciliary body, and anterior retina. The initial histopathologic diagnosis was malignant medulloepithelioma with orbital extension. Closer study revealed a superotemporal chorioretinal and ciliary body coloboma; dysplasia of the adjacent retina; a glioneuromatous mass replacing the temporal ciliary body, chamber angle structures, and iris and extending through the sclera to involve the insertion of the lateral rectus muscle; neuroepithelial elements resembling medulloepithelioma; and abnormally developed iris pigment epithelium, and dilator and sphincter muscles. Immunohistochemistry demonstrated that the main mass consisted of neurons positive for neuron-specific enolase (NSE), synaptophysin and neurofilaments, and glial cells expressing vimentin, glial fibrillary acidic protein, and S-100 protein. The neuroepithelial elements reacted positively for cytokeratins and S-100 protein, in addition to NSE and vimentin, suggesting ciliary epithelial rather than embryonic retinal origin. The tumor was rediagnosed as glioneuroma, which in this case was part of a widespread colobomatous dysplasia of the anterior uvea and retina. The patient is alive without metastases or local recurrence 2 years following enucleation and subtotal removal of the lesion.
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PMID:Glioneuroma associated with colobomatous dysplasia of the anterior uvea and retina. A case simulating medulloepithelioma. 262 23

Over the years 1977-1987 142 patients with malignant melanoma of the uvea were admitted to the Department of Ophthalmology, Teaching Hospital, Comenius University in Bratislava. Of the 119 patients treated by enucleation of the bulb 74.8% were alive after a mean follow up period of 5.9 years, whereas 25.2% of these patients died of consequences of metastases of the melanoma of the eye. The highest death rate was recorded in the first and second year following enucleation (57%) and then in the fourth year (17%). After the eighth year following enucleation of the bulb not a single case of death from consequences of metastases of melanoma was recorded. Eight patients with localization of the tumor in the anterior part of the uveal tract (iris, ciliary body) were treated by microsurgical removal of the tumor from the bulb. Two patients developed relapse of the tumor and the eyeballs had to be enucleated. After a mean follow up period of 6.6 years all these patients are alive and so far no signs of metastases have been observed. Moreover, the visual acuity has remained good in the patients whose eyes were not enucleated. Electrocoagulation was applied in six patients. Within a year the eyes had to be enucleated in three of them due to tumor progression. In two patients the growth of the tumor seems to have been stopped, yet regression of the tumor has not been observed. Complete healing was recorded only in one patient. After a mean follow up period of 4.5 years all the patients are alive without signs of metastases. A series of eight patients refused any kind of treatment of melanoma. Over a follow up period of 8.5 years six of them (75%) died of consequences of metastases within an average of 3.2 years from the establishment of diagnosis. Although the majority of these cases had small and middle sized melanomas, at present only two patients (25%) are still alive. In 127 patients with histologically proved malignant melanoma of the uvea the LAI test for the determination of uveal tumor antigen was also performed. The test was positive in 78.7% of the patients and negative in 23.3%. In a control group of patients with nontumorous eye diseases the LAI test was positive only in 2.9% and negative in 91.1%. Four months after enucleation of the bulb the LAI test was repeated and positivity was found to persist in 57.8% of the patients.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Antitumor immunity in patients with melanoma of the uveal tract]. 279 May 4


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