Cases reported "Uveal Neoplasms"

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1/327. Early-onset scleral necrosis after iodine I 125 plaque radiotherapy for ciliochoroidal melanoma.

    A 62-year-old man with a large ciliochoroidal melanoma developed early-onset scleral necrosis with tumor extrusion within 1 month of epibulbar iodine I 125 plaque radiotherapy. The eye was enucleated. Pathologic study revealed nonmicrobial scleral necrosis with extrusion of histologically intact and necrotic uveal melanoma cells. The patient has been followed up for 15 months without clinical recurrence. We discuss possible mechanisms to explain the early development of scleral necrosis after plaque therapy in this patient. ( info)

2/327. ciliary body melanocytoma with anterior segment pigment dispersion and elevated intraocular pressure.

    PURPOSE: To discuss a case in which melanocytoma of the ciliary body presented with widespread pigment dispersion and elevated intraocular pressure (IOP). methods: A 64-year old woman presented with increased IOP and persistent anterior segment inflammation in her right eye. She had undergone a trabeculectomy for uncontrolled IOP before presentation. Slit-lamp examination, gonioscopy, and ultrasound biomicroscopy revealed a ciliary body mass with extension into the subconjunctiva in addition to widespread pigmentary dispersion in the anterior segment. Enucleation of the right eye was performed for histopathologic evaluation, as a diagnosis of ciliary body melanoma was made on clinical examination. RESULTS: Histopathologic findings were diagnostic of a melanocytoma of the ciliary body with necrosis and focal malignant transformation with extension of melanocytoma cells and melanophages into the subconjunctival space, trabecular meshwork, and anterior chamber angle. CONCLUSION: Melanocytoma of the ciliary body is a rare intraocular tumor that may present with pigment dispersion and secondary elevated IOP. Careful examination of the anterior segment is imperative in such cases. ( info)

3/327. adenocarcinoma of the nonpigmented ciliary body epithelium: report of a rare case.

    Acquired tumours of the nonpigmented ciliary body epithelium are rare. We present herein a case of low-grade adenocarcinoma in order to stress the problems related to the clinical diagnosis. The tumour in our case was circumscribed, localised on the ciliary body, and nonpigmented. The height of the tumour, measured with ultrasound biomicroscopy, was 3.5 mm. The internal reflectivity of the tumor was homogeneous with low attenuation. The tumour was surgically excised with an uneventful iridocyclectomy. Both clinical presentation and preoperative examinations allowed to circumscribe the correct diagnosis which could be confirmed only with histology. ( info)

4/327. Malignant transformation of an optic disk melanocytoma.

    PURPOSE: To report a case of malignant transformation of an optic disk melanocytoma with a second melanocytoma in the ciliary body. methods: Clinical data including visual acuity, visual fields, color fundus photographs, fluorescein angiogram, and ultrasonogram and histopathologic studies of this case were reviewed. RESULTS: The right eye of a 65-year-old white woman was diagnosed with melanocytoma of the optic nerve. Four years later, the tumor became significantly larger. The best-corrected visual acuity declined from 20/40 to counting fingers and the size of the tumor increased fourfold in 2 years. The right globe was enucleated. Histopathologic studies demonstrated moderately pigmented spindle-B malignant melanoma cells adjacent to and within a population of large, polyhedral, heavily pigmented melanocytoma cells that extended to the lamina cribrosa and optic nerve. There was also a deeply pigmented melanocytoma in the ciliary body. CONCLUSION: This is a rare case of malignant melanoma transformed from an optic disk melanocytoma. Periodic follow-up of the patient with optic disk melanocytoma is necessary. ( info)

5/327. Ring melanoma--a rare cause of refractory glaucoma.

    BACKGROUND: Ring melanoma of the ciliary body and iris is extremely rare and often has adverse histology. This tumour may cause raised intraocular pressure. methods: A review of four cases of ring melanomas with insidious presentations seen in the ocular oncology service over a 12 month period. RESULTS: All four patients presented with unilateral anterior segment abnormalities and refractory glaucoma. The misdiagnoses of the causes of the glaucoma included angle recession from previous blunt trauma (patient 1); iridocorneal endothelial (ice) syndrome supported by endothelial specular microscopy (patients 2 and 3); and melanocytoma on ciliary body biopsy (patient 4). Two patients were treated by several cyclodiode ciliary body ablation treatments and the other two underwent trabeculectomies and Molteno tubes. Two of the four patients have since died from their disease. CONCLUSION: The ophthalmologist should re-evaluate the diagnosis in patients with anterior segment abnormalities and refractory ipsilateral glaucoma. Endothelial specular microscopy and biopsy of the suspicious lesion may give misleading reassurance. The potential presence of an anterior uveal melanoma must always be considered. ( info)

6/327. Multifocal intraocular malignant melanoma: report of two cases and review of the literature.

    PURPOSE: To describe two eyes from two patients with multifocal primary intraocular melanoma. DESIGN: Two case reports. methods: The history and histologic findings in the enucleated eyes of two patients with multifocal intraocular melanoma are described in comparison to previously reported cases. MAIN OUTCOME MEASURES: Pathologic examination of enucleated eyes. RESULTS: One of the two eyes contained mixed cell type melanomas, and one eye contained spindle cell type melanomas. Examination of serial sections showed no continuity between the intraocular melanomas. There were no associated ocular or systemic conditions with the multifocal intraocular melanomas. CONCLUSIONS: Multifocal primary intraocular melanoma is rare. There is no known predisposing factor to this condition. ( info)

7/327. indocyanine green iris angiography of lung carcinoma metastatic to the iris.

    BACKGROUND: To investigate the usefulness of indocyanine green (ICG) iris angiography for monitoring vascular abnormalities and the clinical course of metastatic iris tumor during chemotherapy. methods: We performed ICG iris angiography at several points during systemic chemotherapy for a 67-year-old man who had been diagnosed as having small-cell carcinoma of the lung with metastatic iris tumors. RESULTS: ICG iris angiography clearly demonstrated hyperfluorescent tumor vessels, rubeosis iridis, and dilated iris stromal vessels. After chemotherapy, these hyperfluorescent vessels and rubeosis regressed. CONCLUSION: ICG iris angiography appears to be an effective and useful method for observing abnormal vessels associated with metastatic iris tumors. ( info)

8/327. Intraocular metastases of cutaneous malignant melanoma: a case report and review of the literature.

    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. ( info)

9/327. ciliary body schwannoma.

    PURPOSE: Intraocular schwannomas are very rare, benign, peripheral nerve neoplasms. The authors report a case of ciliary body schwannoma. METHOD: A 39-year-old Korean woman presented with slowly decreasing visual acuity and proptosis of the right eye for 4 years. At the time of her visit, the eyeball protruded and deviated laterally. She could not sense light with her right eye. We enucleated the eyeball. The enucleated eyeball with tumor was examined histopathologically, immunohistochemically, and under electron microscope. RESULTS: Microscopic examination revealed spindle cells and characteristic Antoni type A and B areas with Verocay bodies. Immunohistochemical study showed tumor cell expressions of S-100 and vimentin, but other immunohistochemical studies were negative. Electron microscopic examination demonstrated Luse body. CONCLUSIONS: We diagnosed the tumor as a schwannoma arising from the ciliary body on the basis of the above mentioned results. Schwannomas are very rare intraocular neoplasms, but they are benign so we should differentiate from other intraocular neoplasms. ( info)

10/327. Bilateral granulomatous panuveitis as initial presentation of diffuse systemic T cell lymphoma.

    A high-grade diffuse T cell lymphoma, initially simulating bilateral panuveitis, was diagnosed by analysis of a vitreous biopsy specimen and a breast tumor in a 57-year-old woman. It responded favorably to aggressive chemotherapy before it relapsed in leukemic transformation. This case emphasizes the misleading initial symptoms of primary intraocular lymphoma and the role of immunophenotyping in the diagnosis and classification of lymphoproliferative ocular disorders. The presentation and management of uveal lymphoid neoplasia are discussed. ( info)
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