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

We evaluated visual outcome and risk of metastases in patients who underwent cataract extraction after protonbeam irradiation of a uveal melanoma. A total of 84 patients underwent cataract extraction between 2 months and 11 years after irradiation. One year after cataract extraction, approximately half of the patients had visual acuity of 20/100 or better, and approximately one third had an acuity of 20/40 or better. Larger tumor size was highly correlated with poor visual outcome 1 year after extraction. Six patients underwent enucleation after cataract removal, five due to blind, painful eyes and one due to continued growth of a previously undiagnosed ring melanoma. The rate of metastases was not higher among patients who underwent cataract extraction (adjusted rate ratio, 0.83). Results suggest that cataract extraction offers improvement of vision in selected eyes previously irradiated for a uveal melanoma, without adding to the risk of metastases among patients undergoing the procedure.
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PMID:Cataract extraction after proton beam irradiation for malignant melanoma of the eye. 156 50

Recent trends in the treatment of retinoblastoma have favored radiation therapy as opposed to enucleation. A major determining factor in selecting radiation therapy is the possibility of useful posttreatment visual function. While the treatment of nonmacular tumors seems reasonable, little information is available about the posttreatment visual outcome of large posterior pole tumors. We treated 17 patients (20 eyes) with group III-V retinoblastoma and large posterior pole tumors with external beam radiation. Visual acuity after treatment ranged from 5/200 to 20/50. Potential posttreatment visual function was difficult to predict using such pretreatment factors as age at diagnosis, funduscopic appearance, and the number, size, and location of the tumors. Surprising visual function was obtained in some patients with multiple large macular tumors. Follow up ranged from 1 to 8 years. No patient developed metastatic disease; however, four patients required subsequent cataract extraction. This study supports the consideration of radiation therapy as the primary treatment in eyes previously felt to have a poor visual outcome.
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PMID:Visual acuity after successful treatment of large macular retinoblastoma. 158 70

Forty-five patients with retinoblastoma were treated at Keio University Hospital from 1970 to 1990. Thirty-two patients had unilateral lesions and 13 had bilateral lesions. Twenty-nine patients with unilateral and 12 with bilateral lesions underwent enucleation for advanced tumor. As a result, 3 patients with unilateral retinoblastoma and all patients with bilateral disease were treated with radiotherapy (40-50 Gy) combined with or without cryotherapy and/or photocoagulation. One patient with unilateral lesion treated with radiotherapy and chemotherapy had metastases at the first visit to our clinic and was excluded from this analysis. Among 16 eyes (15 patients) treated with radiotherapy, 6 eyes had recurrence and needed retreatment. Cataract occurred in 6 of 12 eyes and good vision was preserved in 5 of 10 eyes in which function could be evaluated.
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PMID:[Radiation management of retinoblastoma]. 164 12

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

The authors reviewed the postoperative course, visual results, histopathologic findings, and mortality data on 95 consecutive patients with tumors of the ciliary body and/or choroid who were managed by a partial lamellar sclerouvectomy. This surgical procedure is designed to remove the uveal tumor and leave intact the outer sclera and sensory retina. In this group of 95 patients, vitreous hemorrhage occurred in 79 (83%) cases, intraretinal or subretinal hemorrhage in 33 (35%), retinal detachment in 26 (28%), and cataract in 32 (34%). Most of the vitreous and retinal hemorrhages resolved spontaneously, sometimes leaving subretinal or preretinal fibrosis. A number of the postoperative retinal detachments resolved spontaneously, but retinal detachment surgery was necessary in 16 patients (17%), mostly in the earlier years of the survey. Most of the cataracts were mild and did not require surgery. The eventual postoperative visual acuity was equal to or better than the preoperative visual acuity in 23 cases (24%) over a mean follow-up period of 5 years. Enucleation was eventually necessary in 15 cases (16%), usually because of residual or recurrent tumor. Histopathologic diagnosis was uveal melanoma in 81 cases (85%) and other tumors in 14 cases (15%). There were no orbital recurrences, but distant metastases developed in five patients (5%), all of whom had undergone enucleation for recurrence of the intraocular melanoma. Although the surgical technique is difficult, partial lamellar sclerouvectomy appears to be a reasonable therapeutic option in selected cases of posterior uveal tumors.
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PMID:Partial lamellar sclerouvectomy for ciliary body and choroidal tumors. 186 53

Between 1983 and 1987, 56 patients with choroidal melanoma were treated at the University of Southern California with episcleral plaque (RPT). There were 29 female and 27 male patients, with a mean age of 59 years. Tumor stage at diagnosis was T2 in 18 (32%) and T3 in 38 (68%) patients. The tumor height ranged from 2.9 to 15 mm (mean 6.8 mm). Radial dimensions ranged from 5 to 25 mm (mean 13.2 mm), and circumference ranged from 7 to 23 mm (mean 12.3 mm). Most (77%) patients had posteriorly located tumors, including 18% that were juxtapapillary. Custom-designed gold plaques were utilized in this study. Radioactive isotopes used were 125I for 26 procedures or 192Ir for 31 procedures. A total of 56 patients were treated, with one patient having two procedures. Radiation doses at the tumor apex ranged from 29.8 to 165.4 Gy (mean 94.5 Gy), with the dose at 5-mm depth ranging from 70.5 to 430 Gy (mean 161.5 Gy). Follow-up ranged from 29 to 57 months (mean 39 months). The overall 4-year survival was 96%, with a 91% incidence of free-of-disease progression at 4 years. The majority (84%) of patients experienced a decrease in tumor height, with 27 (48%) patients having greater than 50% decrease. Increase in tumor height was noted in 5 (9%) and no change in 4 (7%) patients. Useful vision (greater than 5/200) was observed in 59% of patients, including 21% who had improved vision. Metastatic tumor occurred in 5 (9%) patients, with a mean time to metastases of 14 months. There was a good correlation between radial tumor dimension and metastatic disease, p less than 0.001. Treatment complications were observed in 34 (61%) patients, with cataract and retinopathy being the most common. Enucleation was performed in 11 (20%) patients, with a mean time to enucleation of 14.5 months. Causative factors for enucleation were treatment complications in 6 and tumor progression in 5 patients. Enucleations were required primarily in patients with tumors greater than 8 mm in height (p = 0.009). Improved RPT techniques with three-dimensional dosimetry are needed to reduce the overall incidence of treatment complications. Adjuvant hyperthermia is being investigated in an attempt to improve tumor control in patients with larger tumors.
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PMID:Episcleral radioactive plaque therapy: initial clinical experience with 56 patients. 234 23

The authors report two cases of medullo-epithelioma of ciliary body found in two young children. They describe the main clinical symptoms which are often non specific (cataract, glaucoma). Diagnosis is based on histological findings following enucleation: the tumor is developed from the ciliary body cells and has often a local malignancy. Metastasis are rare.
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PMID:[Eye medulloepithelioma. Apropos of 2 cases]. 262 Apr 15

In Norway, sightsaving therapy in retinoblastoma has only been given to least affected eyes in bilaterally affected children. The results in 8 eyes given external high energy radiotherapy are reported. Additional focal therapy was given to 3 eyes for residual tumours and to one eye with new tumour at the ora serrata. Cataract was treated in 2 of the 3 eyes in which it developed. Vitrectomy was performed in 2 eyes with vitreous haemorrhage and persisting vitreous haze. Secondary enucleation has been avoided in all eyes 3-9 years after irradiation. One patient developed metastases in the temporal region at the enucleated side. Visual acuity is 6/12-6/6 if the macula has not been destroyed by tumour or focal therapy. Sightsaving therapy is presently also offered to unilateral cases and worst affected eyes in bilateral cases if the eyes belong to Reese-Ellsworth groups I-IV.
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PMID:Sightsaving therapy in retinoblastoma. Experience with external megavoltage radiotherapy. 309 72

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

From Mar. 1958 through Dec. 1977, a series of 48 patients with Non-Hodgkin's lymphoma in the nasal cavity was treated by radiotherapy in our hospital. The incidence of the disease was only 4.8% (48/983) of all malignant lymphomas during the same interval. The ratio of this tumor with the lymphoma arising for the nasopharynx, tonsil and the base of the tongue is 1:2, 1:3, 9:1. It has an equal chance of locating on the left or right, but was bilateral in 4 patients. In 4, the nasopharynx; 3, the maxillary antrum and 14, the neighboring soft tissues were invaded. The stage IA and IIA lesions as treated by radiotherapy gave 1, 3, 5, 10 and 15 year survival rates of 96%, 82%, 78%, 67% and 44% respectively. Stage IIIA lesions gave a 5 year survival of 25%. All patients with stage IIIB and IV lesions as treated by combination of chemotherapy and radiotherapy died within one year. Those involving the neighboring soft tissues and organs could give a 5 year survival of only 25% and 33%. The prognosis was influenced by the stage and radiation technique. The radiation field must be extensive enough to include the whole nasal cavity (cross the middle line by 1 cm), nasopharyx, the ipsilateral maxillary antrum, hard palate and the regional lymphatic areas. An optimum dose of 5000-6000 rad/five-six week is advisable for this kind of tumour. It is suggested that total body or hemibody irradiation be advisable for cases with distant metastases. Late sequela of cataract calls for meticulous protection of the eye during the initial radiotherapy.
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PMID:[Radiotherapy of non-Hodgkin's lymphoma of the nasal cavity--report of 48 cases]. 391 58


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