ABSTRACT
We present the ultrasound and optic coherence tomography follow-up of a presumed choroidal metastasis from a contralateral melanoma. A 53-year-old male was diagnosed with uveal melanoma with extraescleral extension in his left eye. A year later, the fundus examination revealed a flat, gray-green, pigmented choroidal lesion in the right eye. The ultrasonography showed a mass, almost flat, and all these findings were compatible with a choroidal melanocytic lesion with risk factors for growth. One month later, melanocytic skin lesions appeared on the scalp, as well as small tumors. Three months later, an ultrasonography on B scan showed a growth of the tumor size. The patient developed a progressive deterioration and died. Three possibilities can explain the occurrence of a choroidal pigmented tumor in the contralateral eye: first, bilateral primary choroidal melanomas; second, both choroidal tumors are metastatic in origin from an unknown primary melanoma; and third, the contralateral tumor is a metastatic tumor from the primary choroidal melanoma.
Subject(s)
Choroid Neoplasms/secondary , Melanoma/secondary , Uveal Neoplasms/pathology , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Choroid Neoplasms/diagnostic imaging , Choroid Neoplasms/therapy , Combined Modality Therapy , Eye Enucleation , Fatal Outcome , Humans , Hyperthermia, Induced , Male , Melanoma/diagnostic imaging , Melanoma/therapy , Middle Aged , Orbital Implants , Scleral Diseases/pathology , Skin Neoplasms/secondary , Tomography, Optical Coherence , Ultrasonography , Uveal Neoplasms/diagnostic imaging , Uveal Neoplasms/therapySubject(s)
Eyelid Neoplasms/diagnosis , Lymphoma, Large B-Cell, Diffuse/diagnosis , Aged, 80 and over , Atrial Fibrillation/complications , Biomarkers, Tumor/analysis , Eyelid Neoplasms/chemistry , Eyelid Neoplasms/surgery , Female , Humans , Hypertension/complications , Immunoenzyme Techniques , Lymphoma, Large B-Cell, Diffuse/chemistry , Lymphoma, Large B-Cell, Diffuse/surgery , Ophthalmologic Surgical Procedures , Plastic Surgery ProceduresSubject(s)
Angiogenesis Inhibitors/therapeutic use , Antibodies, Monoclonal/therapeutic use , Choroidal Neovascularization/drug therapy , Retinal Degeneration/drug therapy , Retinal Hemorrhage/drug therapy , Vitreous Hemorrhage/drug therapy , Aged , Antibodies, Monoclonal, Humanized , Bevacizumab , Choroidal Neovascularization/diagnosis , Female , Fluorescein Angiography , Humans , Intravitreal Injections , Retinal Degeneration/diagnosis , Retinal Hemorrhage/diagnosis , Subretinal Fluid , Tomography, Optical Coherence , Vascular Endothelial Growth Factor A/antagonists & inhibitors , Visual Acuity , Vitreous Hemorrhage/diagnosisABSTRACT
PURPOSE: To evaluate the role of photodynamic therapy (PDT) for patients with symptomatic choroidal nevi involving the fovea or located near the fovea with subretinal fluid extending to the fovea. MATERIALS AND METHODS: Retrospective review of five patients who underwent PDT for choroidal nevi at two separate centers in Ankara and Barcelona. RESULTS: The mean initial logMAR visual acuity was 0.5 (range: 0 to 1.5). The mean largest tumor base diameter was 3.2 mm (range: 2.1-4.5 mm) and the mean tumor thickness was 1.1 mm (range: 0.7-1.6 mm). The mean number of PDT sessions was 1.6 (range:1-3). The mean final tumor thickness was 1.0 mm (range: 0-1.6 mm) at a mean follow-up of 19 months (range: 12-32 months). The mean final logMAR visual acuity was 0.4 (range: 0-1.5). Subfoveal fluid disappeared or decreased significantly in 4 of 5 eyes (80%) after PDT. CONCLUSIONS: PDT led to resolution of subretinal fluid with preservation of visual acuity in many symptomatic choroidal nevi in this study. Careful case selection is important as PDT of indeterminate pigmented tumors may delay the diagnosis and treatment of an early choroidal melanoma and thereby increase the risk for metastasis.
ABSTRACT
Presentamos un caso de embarazo ectópico cervical tratado con metotrexato e histerectomía abdominal. Mujer de 43 años, con 3 cesáreas previas, diagnosticada en la séptima semana de amenorrea por ecografía transvaginal. El embarazo ectópico cervical es una entidad poco frecuente. Su presentación habitual es una metrorragia irregular en el primer trimestre de gestación. La gonadotropina coriónica beta y la ecografía vaginal resultan fundamentales para el diagnóstico. La histerectomía es una opción terapéutica (AU)
We report a case of cervical ectopic pregnancy treated with methotrexate and abdominal hysterectomy. A 34-year-old woman with three previous cesarean sections was diagnosed with a cervical ectopic pregnancy through transvaginal ultrasound at 7 weeks of amenorrhea. Cervical ectopic pregnancy is an uncommon event that usually presents as irregular bleeding in the first trimester. Diagnosis is based on â-human chorionic gonadotrophin and transvaginal ultrasonography. Hysterectomy is a therapeutic option (AU)
