ABSTRACT
A 53-year-old male presented with a progressive mass of the left orbit. His medical history included an invasive carcinoma of the bladder diagnosed three weeks earlier. An orbital biopsy was performed and the diagnosis was that of an orbital metastasis of urinary bladder carcinoma. The patient developed widespread metastatic disease and unfortunately died one month after the diagnosis of orbital metastasis. Orbital metastasis of urinary bladder carcinoma is associated with a poor prognosis and is more frequently observed in older people. In addition, it is five times more prevalent in men than in women.
Subject(s)
Carcinoma/secondary , Orbital Neoplasms/secondary , Urinary Bladder Neoplasms/pathology , Fatal Outcome , Humans , Male , Middle AgedABSTRACT
PURPOSE: To characterize, in detail, tumor development, malignant cell dissemination, and metastasis in a 10-week animal model of uveal melanoma. METHODS: One million 92.1 human primary uveal melanoma cells were injected into the suprachoroidal space of the right eye of 27 immunosuppressed albino rabbits. Intraocular tumor growth was monitored weekly by fundoscopy and by ultrasonography at the end of the experiment. To document the progression of the disease, one animal per week was killed. The enucleated eyes, lungs, and livers were macroscopically examined and histopathologically studied by hematoxylin and eosin, periodic acid-Schiff, and immunohistochemistry. Mononuclear layers isolated from the rabbits' blood samples were cultured. RESULTS: Histopathology showed intraocular tumors in 89% of the animals. Tumor growth was found 1 week after cell inoculation, and by the end of the experiment large tumor masses were observed. Microscopic pulmonary metastatic foci were first observed 4 weeks after cell injection. By the end of the experiment, all the animals had metastasis to the lungs. Interestingly, 18% of the animals also had micrometastasis to the liver. Viable adherent uveal melanoma cells were successfully isolated from peripheral blood and grown in vitro. CONCLUSIONS: In this study, most rabbits developed intraocular tumors followed by lung metastasis, and some of these rabbits later developed liver micrometastases. This novel source of research material warrants a follow-up longer than 10 weeks to further explore the pathophysiologic bases of liver involvement commonly encountered in humans. The success in the isolation and culture of circulating malignant cells in this animal model suggests that it might be worthwhile to explore the application of this technique to the management of patients with primary uveal melanoma.
Subject(s)
Disease Models, Animal , Liver Neoplasms/secondary , Lung Neoplasms/secondary , Melanoma/secondary , Neoplastic Cells, Circulating/pathology , Uveal Neoplasms/pathology , Animals , Cell Line, Tumor , Male , Melanoma/ultrastructure , Prognosis , Rabbits , Uveal Neoplasms/ultrastructureABSTRACT
BACKGROUND: P-glycoprotein (P-gp) has been identified as a possible mediator of chemoresistance in retinoblastoma. The aim of this study was to determine the expression of P-gp in retinoblastoma treated with chemotherapy prior to enucleation. METHODS: Seventeen enucleated specimens of retinoblastoma from 16 patients were studied. Nine had been treated with chemotherapy alone, and eight had been treated with chemotherapy and other forms of local treatment. Tumour differentiation as well as choroidal and optic nerve invasion were assessed. P-gp immunohistochemical staining was performed and evaluated as negative, low or high. RESULTS: Histopathological assessment of the cases showed that 14 of 17 eyes (82.3%) had viable retinoblastoma cells. Nine retinoblastomas were considered regressed with a well-differentiated component, five regressed retinoblastomas had viable cells with poor differentiation and three retinoblastomas had regressed leaving no viable cells. Sixteen of 17 retinoblastomas were P-gp positive. In the one case with optic nerve invasion and the three cases with massive choroidal invasion, P-gp expression was found in invading retinoblastoma cells. CONCLUSION: Almost all retinoblastomas expressed P-gp. High levels of P-gp expression might play a role in chemotherapy resistance of retinoblastoma or, conversely, chemotherapy might induce P-gp expression. These results might have an impact on management of bilateral retinoblastoma.
Subject(s)
ATP Binding Cassette Transporter, Subfamily B, Member 1/metabolism , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Retinal Neoplasms/metabolism , Retinal Neoplasms/pathology , Retinoblastoma/metabolism , Retinoblastoma/pathology , Brachytherapy , Carboplatin/administration & dosage , Child, Preschool , Combined Modality Therapy , Etoposide/administration & dosage , Female , Humans , Immunoenzyme Techniques , Infant , Male , Neoplasm Invasiveness , Retinal Neoplasms/drug therapy , Retinoblastoma/drug therapy , Vincristine/administration & dosageABSTRACT
PURPOSE: The aim of this study was to report on the possible development of corneal endothelial deposits resulting from the use of rifabutin. METHODS: Case series consisting of 3 patients treated with rifabutin were retrospectively studied. Two of the patients were infected with human immunodeficiency virus. A corneal and external disease specialist performed a complete ophthalmologic exam and obtained medical histories of the patients. RESULTS: All cases developed corneal endothelial deposits after previous use of rifabutin. The deposits were bilateral, yellow-white colored, stellate, and mainly peripheral. CONCLUSIONS: In these 3 cases, the unique positive ocular finding was corneal endothelial deposits, which may be related to the use of rifabutin.
