Assuntos
Anticorpos Monoclonais Humanizados/administração & dosagem , Glaucoma Neovascular/tratamento farmacológico , Melanoma/radioterapia , Prótons/efeitos adversos , Radioterapia de Alta Energia/efeitos adversos , Neoplasias Uveais/radioterapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Glaucoma Neovascular/etiologia , Humanos , Pressão Intraocular , Injeções Intravítreas , Masculino , Pessoa de Meia-Idade , Terapia com Prótons , Ranibizumab , Estudos Retrospectivos , Acuidade VisualRESUMO
BACKGROUND/AIMS: To assess spectral domain-optical coherence tomography (SD-OCT) contribution to choroidal osteoma characterisation. METHODS: A retrospective chart review of a series of patients diagnosed with choroidal osteoma, which included patient, clinical, ultrasonographic, photographic and SD-OCT imaging. RESULTS: 11 patients were included in this series. Their mean age was 42.5 years (median=43.0; range, 14-73). Using statistical analysis, the mean basal diameters of tumours as derived from fundus photographs (5.2 mm) and ultrasound images (6.4 mm) were significantly different (paired t-test, p=0.03). Tumours were SD-OCT hyporeflective in two cases, isoreflective in seven cases and hyper-reflective in two cases. Intrinsic reflectivity of the tumour was inhomogeneous in four cases. The overlying choroid was compressed by the tumour in eight cases and the retina exhibited degenerative changes in five cases. CONCLUSION: This study revealed that SD-OCT provided deeper and higher resolution images of choroidal osteoma when compared with previous studies using time domain-OCT. These findings offer new insights into the pathophysiology and diagnosis of choroidal osteoma.
Assuntos
Neoplasias Ósseas/patologia , Neoplasias da Coroide/patologia , Osteoma/patologia , Tomografia de Coerência Óptica , Adolescente , Adulto , Idoso , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias da Coroide/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoma/diagnóstico por imagem , Estudos Retrospectivos , Ultrassonografia , Acuidade VisualRESUMO
PURPOSE: To report on whole body positron emission tomography/computed tomography (PET/CT) screening for metastasis at diagnosis of primary uveal melanoma. METHODS: Since August 2003, 333 consecutive patients were diagnosed with uveal melanoma and underwent whole body screening for metastatic disease with PET/CT along with liver function tests and physical examination. Abnormal findings prompted further biopsies, blood tests, imaging, or clinical evaluations for confirmation. The presence of metastatic disease and second cancers were evaluated. RESULTS: Using the American Joint Committee on Cancer (AJCC) tumor, node, metastasis (TNM) 7th edition criteria, 104 tumors were classified T1 (31%), 162 T2 (49%), 37 T3 (11%), and 30 T4 (9%). Seven of 333 (2.1%; 95% confidence interval [CI] 0.8-4.3) patients had metastatic melanoma. One tumor was a T3 and 6 were T4. Thus, 3% of T3 and 20% of T4 melanomas were found to have metastases at the time of initial diagnosis. Ten patients (3.3%; 95% CI 0.9-5.5) had synchronous second cancers and 28 (8.4%) concurrent benign lesions. The most common metastatic sites were liver (7/7) and bone (2/7). DISCUSSION: This study suggests that PET/CT improves the yield of detecting both extrahepatic metastases, especially from tumors defined as AJCC-T4, and synchronous primary cancers, irrespective of the size of the uveal melanoma. With respect to liver metastases, PET/CT demonstrated high sensitivity and positive predictive values, indicating an overall better performance than conventional screening procedures.
