Superior orbital fissure syndrome caused by intraorbital spread of a cutaneous squamous cell carcinoma and not detected on computed tomography and magnetic resonance imaging

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Epistaxis or epiphora as a sign for extension of a conjunctival melanoma. A series of six patients with nasolacrimal recurrence

Purpose To characterise malignant conjunctival melanomas with extension and recurrence in the nasolacrimal system. Methods Localisation of the primary tumour and recurrences of 210 conjunctival melanomas treated in The Netherlands were reviewed for orbital and nasal tumours (1978-2008). Based of these cases and literature data, characteristics for nasolacrimal system extension and metastasis were reviewed. Results Six patients (3%) showed a recurrence of the primary conjunctival melanoma in the nasolacrimal system. Two of the six primary tumours were limbal tumours; the other four were diffuse tumours involving the fornix. In all six patients, the primary conjunctival melanomas were associated with primary acquired melanosis. During the follow-up period (11.6 +/- 3 years, range 3.4-28.5 years, median 8.7 years) two patients developed metastases and died. Conclusions Patients should be advised to contact their treating ophthalmologist in the case of symptoms of epiphora, nose obstructions and epistaxis, especially non-bulbar and diffuse cases associated with primary acquired melanosis.Ophthalmic researc

Decreased expression of HLA class II antigens on human uveal melanoma cells after in vivo X-ray irradiation

In order to determine the presence of HLA antigens on human uveal melanomas, we tested anti-HLA monoclonal antibodies on tissue sections of these tumors. A great variety in expression of HLA class I and II antigens was present. A significantly lower expression of HLA class II antigens was present on uveal melanomas that had been irradiated before enucleation. These tumors lacked a lymphocytic infiltrate in comparison with nonirradiated tumors. These data suggest that radiotherapy affects expression of histocompatibility antigens on tumor

Intravascular Presence of Tumor Cells as Prognostic Parameter in Uveal Melanoma: A 35-Year Survey

PURPOSE. Invasion of tumor cells into blood vessels is essential for metastasis of uveal melanoma. The occurrence of ingrowth of tumor cells in blood vessels in uveal melanoma was analyzed, and this parameter was compared with the survival of the patients. METHODS. Between 1972 and 2007, 643 eyes primarily enucleated for uveal melanoma were evaluated histopathologically. Survival data were obtained from charts and from the Integral Cancer Center patient registry. RESULTS. No vascular ingrowth of tumor cells occurred in 59% of the eyes, whereas 18% had tumor cell ingrowth in vessels inside the tumor, 10% in vessels outside the tumor, and 8% in vessels inside as well as outside the tumor. The presence of any intravascular ingrowth of tumor cells correlated significantly with the diameter (P < 0.01) and prominence of the tumor (P < 0.01), as well as with non-spindle-cell type (P = 0.03) and intrascleral ingrowth (P < 0.01), and was associated with a worse survival. When extravascular matrix patterns were not included in the multivariate analysis, intravascular ingrowth came out as an independent prognostic factor, but this was not the case when extravascular matrix patterns were included in the multivariate model. CONCLUSIONS. Intravascular ingrowth of tumor cells in uveal melanoma occurs frequently in combination with well-known histopathologic factors such as large tumor size, epithelioid cell type, and intrascleral ingrowth. (Invest Ophthalmol Vis Sci. 2010; 51: 658-665) DOI: 10.1167/iovs.09-3824Ophthalmic researc

Chromosomal aberrations in iris melanomas

Ophthalmic researc

Immunophenotypic markers to differentiate between benign and malignant melanocytic lesions

BACKGROUND/AIMS: The authors investigated the expression of S100A1, S100A6, S100B, MelanA, and CEA in conjunctival naevi, primary acquired melanosis (PAM), conjunctival melanoma, and uveal melanoma in order to assess their potential usefulness in the pathological differential diagnosis of these entities. METHODS: Paraffin embedded sections of 18 conjunctival naevi, 14 PAM, 16 conjunctival melanomas, and 20 uveal melanomas were immunostained for S100A1, S100A6, S100B, MelanA, and CEA, and expression was scored semiquantitatively. RESULTS: Expression of S100A1 differed significantly between conjunctival naevi and conjunctival melanoma, with percentages of positive cells of 30.6% and 71.4%, respectively. Conjunctival melanomas had high average scores for S100A1 and S100B (71.4%, 62.9%, respectively), while uveal melanomas also had high S100A1 but low S100B scores (88.5%, 18.5%, respectively). MelanA was highly variable; naevi and uveal melanoma had higher average scores than conjunctival melanoma. CEA was hardly detectable in all four groups. CONCLUSION: S100A1 seems to be a possible candidate to differentiate conjunctival naevi from conjunctival melanoma. S100B seems to differentiate between uveal melanoma and conjunctival melanoma. However, the study size was small and therefore the data have to be confirmed by others

Hematoporphyrin derivative photoradiation treatment of experimental malignant melanoma in the anterior chamber of the rabbit

The effects of Hematoporphyrin Derivative Photoradiation Therapy (HpD-PRT) on Greene's amelanotic melanoma implanted into the anterior chamber of rabbits have been examined by biomicroscopy, fluorescein angiography and histopathology. The tumors were irradiated 24 hours after injection of HpD when both the porphyrin concentration and the porphyrin ratio tumor/iris were highest. Blanching and shrinkage of tumors were the first signs of tumor destruction. Fluorescein angiography as soon as 20 minutes after irradiation found non-perfusion of blood vessels at the tumor surface. Histopathological observation of vessel wall destruction is in agreement with this finding. Subtotal tumor necrosis was demonstrated in 12 out of 13 experiments. Necrosis was complete in only one experiment. Clusters of viable tumor cells were found when shielded behind pigment, at the tumor periphery and around some blood vessels. Lens damage was observed after irradiation when the iris pigment epithelium was disorganized by the tumor. The iris contained high concentrations of porphyrin and PRT resulted in depigmentation, non-perfusion of the capillary bed, damage to larger iris vessels and finally atrophy. Light intensity measurements were performed in vivo during PRT. The average effective attenuation coefficient at 630 nm was 0.56 mm-1 at the beginning of irradiation and 0.87 nm-1 at the end. Results indicate that as a treatment HpD-PRT in itself might be insufficient but may prove to be an effective modality in combination with other tumor destructive therapie