ABSTRACT
CASE REPORT: We report a case of choroidal melanoma metastatic to the liver diagnosed by fine-needle aspiration. The biopsy sample was immunostained for COX-2 and c-kit. COMMENTS: Accurate diagnosis and identification of potential therapeutic targets are important for subsequent therapy and can be achieved by radiologically guided fine-needle aspiration biopsy.
Subject(s)
Choroid Neoplasms/metabolism , Cyclooxygenase 2/metabolism , Liver Neoplasms/metabolism , Melanoma/metabolism , Proto-Oncogene Proteins c-kit/metabolism , Aged , Biopsy, Needle , Choroid Neoplasms/pathology , Humans , Immunohistochemistry , Liver Neoplasms/secondary , Male , Melanoma/secondaryABSTRACT
PURPOSE: To investigate the expression of P-glycoprotein (P-gp) in retinoblastoma specimens enucleated as a primary treatment or after conservative treatment and to correlate this expression with histopathological tumor features. METHODS: Retrospective analysis was performed on retinoblastoma specimens obtained consecutively between 1993 and 2003 by enucleation either as primary treatment (group I) or after the failure of conservative treatment (group II). Sections from the formalin-fixed, paraffin-embedded specimens were stained with hematoxylin and eosin. Group I tumor differentiation was classified according to the percentage of Flexner-Wintersteiner rosettes. Group II tumors, categorized as viable-appearing, regressed with a well-differentiated component (WDC), and regressed. Other features, such as choroidal and optic nerve invasion, were evaluated. P-gp expression was graded semiquantitatively as negative, low, or high. Variables were statistically analyzed by chi(2) and Student's t-tests. RESULTS: Histopathological assessment of group I revealed 65% moderately differentiated tumors, 30% well differentiated, and 5% poorly differentiated. Fifteen percent had optic nerve tumor invasion only, 20% choroidal invasion only, and 55% both choroidal and optic nerve invasion. Group II had 62.5% well-differentiated, regressed tumors; 25% had regressed tumors replaced by glial scarring; and 12.5% had tumors containing viable, poorly differentiated cells. Approximately 18% had choroidal tumor invasion only, 6.3% optic nerve tumor invasion only, and 6.3% simultaneous optic nerve and choroidal invasion. P-gp expression was observed in 60% of group I and 66.6% of group II. All P-gp-positive cases in group II had a high expression. P-gp was also expressed by 81.2% of well-differentiated tumors. CONCLUSIONS: P-gp was expressed more frequently by well-differentiated retinoblastomas, especially those treated by chemotherapy before enucleation. This finding could be related to treatment failure.
Subject(s)
ATP Binding Cassette Transporter, Subfamily B, Member 1/metabolism , Retinal Neoplasms/metabolism , Retinal Neoplasms/pathology , Retinoblastoma/metabolism , Retinoblastoma/pathology , Antineoplastic Agents/therapeutic use , Cell Differentiation , Child, Preschool , Eye Enucleation , Female , Humans , Immunoenzyme Techniques , Infant , Male , Neoplasm Invasiveness , Retinal Neoplasms/therapy , Retinoblastoma/therapy , Treatment FailureABSTRACT
A 43-year-old white woman presented with a sudden pain and protrusion of the right eye, along with decreased vision. Orbital CT revealed a well-demarcated lesion in the right intraconal space. After surgical excision, the histopathologic examination revealed a malignant melanoma with a predominant epithelioid cell type, probably arising in a blue nevus. The patient was treated with exenteration followed by radiotherapy.
Subject(s)
Melanoma/pathology , Neoplasms, Second Primary/pathology , Nevus, Blue/pathology , Orbital Neoplasms/pathology , Adult , Combined Modality Therapy , Exophthalmos/diagnosis , Female , Humans , Melanoma/diagnostic imaging , Melanoma/therapy , Neoplasms, Second Primary/diagnostic imaging , Neoplasms, Second Primary/therapy , Nevus, Blue/diagnostic imaging , Nevus, Blue/therapy , Orbit Evisceration , Orbital Neoplasms/diagnostic imaging , Orbital Neoplasms/therapy , Pain/diagnosis , Radiotherapy Dosage , Tomography, X-Ray Computed , Vision Disorders/diagnosisABSTRACT
PURPOSE: To report the visual prognosis and longterm complications in patients with multifocal choroiditis and panuveitis (MCP). METHODS: A retrospective study was performed with patients who met inclusion criteria for MCP at the Uveitis Clinic, Royal Victoria Hospital, McGill University, Montreal, Canada. Information collected included duration of follow-up, visual acuity (VA) measured at each clinical visit, ocular and systemic treatment and ocular complications observed during follow-up. RESULTS: Nineteen patients (37 eyes) with MCP with a mean follow-up of 76.9 months were studied. Kaplan-Meier survival analysis showed a decrease in the proportion of patients with a final VA > or = 20/40 over time. Cystoid macular oedema was seen in 29.7% of the eyes and was the most frequent macular abnormality observed in our group. On the other hand, choroidal neovascularization was detected in only six (16.2%) of the eyes, but was related to VA < 20/200 in four of these eyes. Glaucoma was detected in 10.8% of the eyes. Cataract (posterior subcapsular and/or nuclear) was the most common longterm complication, occurring in 40% of affected eyes. Cataract surgery improved the VA in 83.3% of these eyes. CONCLUSION: The visual acuity of patients with MCP decreases with time. Visual loss can occur from complications following the inflammation itself and/or iatrogenic induced by the chronic use of corticosteroids.
