Cases reported "Choroid Neoplasms"

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1/676. Translocation of chromosomes 11 and 22 in choroidal metastatic Ewing sarcoma detected by fluorescent in situ hybridization.

    PURPOSE: To describe a patient with metastasis of Ewing sarcoma to the choroid and the molecular genetics of the tumor. methods: A 26-year-old woman with metastatic Ewing sarcoma developed large choroidal masses in the left eye and died 2 months later. autopsy of the eyes was performed. Dual-color fluorescent in situ hybridization was used to detect genetic alteration in the ocular tumor with EWS and FLI-1 probes. RESULTS: Histopathology confirmed choroidal metastatic Ewing sarcoma. Molecular analysis showed chromosomal translocation t(11;22)(q24;q12) or EWS/FLI-1 rearrangement in the malignant cells of the eye. CONCLUSIONS: Ewing sarcoma can rarely metastasize to the uvea. Molecular detection of the t(11;22)(q24;q12) translocation in Ewing sarcoma is valuable in the differential diagnosis of small round cell tumors. ( info)

2/676. Multifocal choroidal malignant melanoma: at least 3 melanomas in one eye.

    OBJECTIVES: To describe a case of an enucleated eye harboring multiple choroidal malignant melanomas. methods: Clinical, ultrasonographic, and histopathological evaluations. RESULTS: Meticulous sectioning of the globe did not disclose any structural continuity between the 3 choroidal melanomas. Fourth and fifth masses were connected to one of the tumors by fibrous tissue and therefore were not considered as additional distinct lesions. CONCLUSION: Although very rare, a single eye can harbor multiple distinct choroidal melanomas. ( info)

3/676. 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)

4/676. Radioactive phosphorus uptake testing of choroidal lesions. A report of two false-negative tests.

    Two false-negative results from 32P testing for histologically verified malignant melanomas of the choroid are reported. In the first case, a haemorrhagic choroidal detachment caused an increase in probe; additionally, the tumour was necrotic. Both factors are likely to have contributed to the false-negative result. A satisfactory explanation for the false-negative result in the second case was not determined, although it may have accurately reflected a period of minimal tumour activity, inasmuch as repeat 32P testing was strongly positive eight months later, when unequivocal evidence of tumour growth was present. An alternative explanation is that the orally administered 32P was incompletely absorbed. Since 32P testing is frequently accompanied by significant manipulation both in the manoeuvre associated with tumour localization and in that associated with the actual radioactive counting, it would seem desirable to perform indicated enucleation immediately after completion of the 32P testing. While the properly performed 32P test remains a valuable diagnostic test for helping to establish the presence or absence of malignancies of the posterior globe, it is important to guard against the tendency to underestimate careful clinical evaluation. ( info)

5/676. Iatrogenic breaks in Buuch's membrane in choroidal melanoma.

    Three patients with choroidal melanoma have been observed to develop subretinal hemorrhages associated with their ocular examinations. One hemorrhage appears to have been caused by transillumination, while two others have occurred during radioactive phosphorus testing. Histopathology confirms defects in Bruch's membrane through which blood or tumor cells have entered the subretinal space. ( info)

6/676. Clinical experience with presumed hemangioma of the choroid: radioactive phosphorus uptake studies as an aid in differential diagnosis.

    A total of 27 cases of choroidal hemangioma was evaluated with radioactive phosphorus uptake studies. In each case the diagnosis of malignant melanoma was initially entertained, but the 32P test was unequivocally negative in every instance. follow-up studies in every case have supported the clinical diagnosis. In 22 patients, the lesion was treated with photocoagulation, and in every treated case the serous macular detachment disappeared. The importance of early and correct clinical diagnosis is stressed, since these are salvageable and potentially useful seeing eyes. ( info)

7/676. Tumor growth of a choroidal malignant melanoma and aqueous flare. Report of a case.

    We report the use of the laser flare-cell meter (LFCM) in monitoring blood-ocular barrier breakdown induced by a choroidal malignant melanoma in an 88-year-old white male, who refused enucleation or radiation treatment. During a follow-up of 16 months, aqueous flare values measured with the LFCM increased from 12.8 to 26.5 photon counts/ms with continuous tumor growth from a height of 7.9 to 18 mm. Our finding of increasing flare values with tumor growth appears to confirm the observation that aqueous flare is influenced by the size of uveal malignant melanomas. Quantification of aqueous flare with the LFCM may be helpful in the follow-up of eyes with intraocular tumors. ( info)

8/676. Transpupillary thermotherapy in the management of circumscribed choroidal hemangioma.

    PURPOSE: To report a case of circumscribed choroidal hemangioma effectively managed with transpupillary thermotherapy. METHOD: A 53-year-old man affected by extramacular circumscribed choroidal hemangioma had sustained a decline in visual acuity caused by subretinal fluid exudation into the macular area. Multiple attempts at treatment with scatter photocoagulation over the surface of the lesion for several years had been unsuccessful in reducing tumor-related exudation. The patient was examined on referral and underwent a single session of treatment employing transpupillary thermotherapy. The course of the lesion after treatment was documented with fundus photography and ultrasonography. RESULT: Complete atrophy of the choroidal hemangioma with resorption of subretinal fluid was documented over the 6 months after transpupillary thermotherapy, with improvement in visual acuity. CONCLUSION: Transpupillary thermotherapy is an effective alternative to conventional scatter photocoagulation or radiation therapy for precise ablation of circumscribed choroidal hemangioma. ( info)

9/676. Malignant melanoma of the choroid in neurofibromatosis.

    A 60-year-old white woman with generalized neurofibromatosis and multiple melanocytic hamartomas of the iris developed an unusual choroidal mass, with secondary sensory retinal separation in the left eye. Ophthalmoscopically the tumor had a peculiar donut configuration that was caused by a large focus of central necrosis within a spindle B melanoma. ( info)

10/676. Proton beam therapy for posterior pole circumscribed choroidal haemangioma.

    BACKGROUND: Macular and juxtapapillary circumscribed choroidal haemangiomas (CCH) have always posed a diagnostic and therapeutic challenge. Proton beam therapy has been advocated by Zografos and associates as optimal for treating these tumours in this critical region as charged particles have a highly localised and uniform dose distribution. patients: We present 3 cases of CCH treated with proton beam therapy. Two patients developed radiation optic neuropathy and maculopathy, and one had a persistent exudative macular detachment following treatment. CONCLUSION: Our experience with proton therapy of these tumours has been disappointing in preventing radiation optic neuropathy and maculopathy and offers little advantage over external irradiation. The majority of our patients with this condition are now treated with low-dose lens-sparing external beam radiotherapy or brachytherapy, which has encouraging visual results and is a far more cost-effective option. ( info)
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