John P Gorham1, Eszter Szalai1, Jill R Wells1, Hans E Grossniklaus1,2. 1. Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA. 2. Department of Pathology, Emory University School of Medicine, Atlanta, Georgia, USA.
Abstract
PURPOSE: To describe the clinical history and histopathologic findings of 2 cases of retinoinvasive uveal melanoma. METHODS: The medical records and pathology specimens of 2 patients with retinoinvasive uveal melanoma were reviewed. RESULTS: The first patient had an iris/ciliary body melanoma that was treated and the second patient had suspected iridocorneal endothelial syndrome. Both patients developed a blind, painful eye; the first patient's right eye was enucleated and the left eye of the second patient underwent evisceration. Histopathologic examination of the enucleated eye showed a tumor composed of minimally pigmented spindle-shaped cells with fusiform nuclei and prominent nucleoli and round cells with prominent nucleoli. The tumor cells invaded into the retina where they formed perivascular aggregates. Examination of the evisceration specimen showed a proliferation of pigmented tumor cells within the stroma of one iris leaflet. The tumor cells extended onto the ciliary body and vitreous base and invaded the retina. The pathologic diagnosis in both patients was retinoinvasive uveal melanoma. CONCLUSIONS: Careful funduscopic and imaging examination should be performed in eyes with unilateral glaucoma with iris/ciliary body lesions, and enucleation, rather than evisceration, should be performed, as retinoinvasive melanoma is in the differential diagnosis.
PURPOSE: To describe the clinical history and histopathologic findings of 2 cases of retinoinvasive uveal melanoma. METHODS: The medical records and pathology specimens of 2 patients with retinoinvasive uveal melanoma were reviewed. RESULTS: The first patient had an iris/ciliary body melanoma that was treated and the second patient had suspected iridocorneal endothelial syndrome. Both patients developed a blind, painful eye; the first patient's right eye was enucleated and the left eye of the second patient underwent evisceration. Histopathologic examination of the enucleated eye showed a tumor composed of minimally pigmented spindle-shaped cells with fusiform nuclei and prominent nucleoli and round cells with prominent nucleoli. The tumor cells invaded into the retina where they formed perivascular aggregates. Examination of the evisceration specimen showed a proliferation of pigmented tumor cells within the stroma of one iris leaflet. The tumor cells extended onto the ciliary body and vitreous base and invaded the retina. The pathologic diagnosis in both patients was retinoinvasive uveal melanoma. CONCLUSIONS: Careful funduscopic and imaging examination should be performed in eyes with unilateral glaucoma with iris/ciliary body lesions, and enucleation, rather than evisceration, should be performed, as retinoinvasive melanoma is in the differential diagnosis.
Authors: Tatyana Milman; Dan-Ning Hu; Steven A McCormick; Ralph C Eagle; J Brooks Crawford; Kimberly Chin; Carol L Shields; Jerry A Shields; Devron H Char; Paul T Finger Journal: Melanoma Res Date: 2012-04 Impact factor: 3.599