Metastatic tumors are the most common intraocular malignancies in adults. Anterior segment metastases account for about 7.2-14.1% of all intraocular metastatic tumors with those to the iris ...representing 3.6-7.8% of the cases. Breast and lung are the most frequent primary sites of metastasizing cancer. The aim of this study is to present the case of a 43-year-old patient with a rare small-cell lung carcinoma metastasis to the iris.
A patient with small-cell lung carcinoma and metastases in the brain who had been treated with chemo- and radiotherapy attended an outpatient clinic because of redness of her left eye. Based on the ophthalmological examination, a diagnosis of numerous metastatic tumors to the iris was made and the patient was referred for re-chemotherapy. Complete regression of the iris lesions was observed after 5 months but unfortunately two months later the patient died, due to progression of her systemic disease.
Among lung cancers, adenocarcinomas are much more likely to produce distant metastases to the iris than small-cell carcinomas 4. More than 50% of patients with small-cell lung carcinoma have metastases in the brain. The survival rate in cases of lung cancer with eye involvement is poor and approximates to 7 months. However, since there is a strong probability of angle involvement and subsequent secondary glaucoma, the early onset of treatment can improve the patient's quality of life during the terminal phase of the disease.
Retinal pigment epithelium hamartomas are rare, benign tumors, usually with no growth potential. The case of hamartoma observed at the Ocular Oncology Service, Department of Ophthalmology, University ...of Medical Sciences in Poznań is presented. In 2008 a 30-year-old woman presented with an asymptomatic choroidal pigmented lesion. Fundus evaluation revealed a lesion typical of retinal pigment epithelium hamartoma. The optical coherence tomography, fluorescein angiography and indocyanine green angiography results confirmed the diagnosis of retinal pigment epithelium hamartoma. No lesion growth was documented throughout the follow-up period of 4 years. Differential diagnosis between congenital retinal pigment epithelium hypertrophy (congenital hypertrophy of the retinal pigment epithelium) or uveal melanoma was included in the report. retinal pigment epithelium hamartoma, fluorescein angiography, optical coherence tomography.
To report choroidal melanoma treatment by endoresection.
A retrospective review of a series of 2 patients with choroidal melanoma that did not meet the criteria for brachytherapy. Both patients were ...treated by tumor endoresection supported by brachytherapy. Outcome measures included preoperative and postoperative visual acuity at 1, 3, 6 months. Preoperative evaluation included tumor measurements in ultrasound. Systemic evaluation (liver function test, chest x ray, abdominal ultrasound), was carried out to monitor possible metastases in the observation period.
The two operated patients were followed-up for 6 months. Visual acuity deteriorated from 5/16 (0.51 logMAR) preoperatively to 5/25 (0.7 logMAR) postoperatively in patient 1, and improved from 3/50 (1.22 logMAR) do 5/25 (0.7 logMAR) in patient 2. This corresponded to deterioration by 0.19 logMAR and improvement by 0.52 logMAR respectively. Neither tumor recurrence nor metastases were detected in the follow-up period.
Endoresection is a treatment option, alternative to enucleation, that can conserve the eye It sometimes can be performed in eyes that are not eligible for trans-scleral resection. Further larger studies are needed to establish the efficacy of this still controversial surgery.
To report autologous choroidal RPE patch transplantation for treatment of submacular hemorrhage in a patients with age related macular degeneration.
A case report of a patient with sudden vision ...deterioration due to submacular hemorrhage in AMD. The visual acuity was 5/5 in the right eye and 0.5/50 in the left eye. He was treated with autologous choroidal RPE patch transplantation. Outcome measures included preoperative and postoperative visual acuity at 1, 3, 6 months, duration of hemorrhage, hemorrhage size on preoperative fluorescein angiography and thickness of the subretinal hemorrhagic complex on preoperative and postoperative OCT scans.
Visual acuity improved from 0.5/50 to 5/50 in 6 months follow-up. No major intraoperative and postoperative complications were observed. The perfusion of the graft was confirmed in ICG angiography.
Autologous choroidal RPE patch transplantation is an effective option for submacular hemorrhage treatment in AMD. Unlike macular translocation, the surgery can be performed even in patients with excellent visual acuity in the fellow eye.
AIMTo present a case of neoadjuvant treatment of uveal melanoma with a limited core endoresection, which enabled ruthenium plaque radiotherapy to be administered. MATERIAL AND METHODSA 77-year-old ...woman presented in 2005 with a ciliochoroidal uveal melanoma measuring 7.2 by 6.5 mm basally with a thickness of 6.2 mm. The vision in the affected eye was 6/9. Because of diagnostic uncertainty, we performed a biopsy, which produced a copious sample. The biopsy serendipitously reduced the tumour thickness to 4.4 mm, making ruthenium plaque brachytherapy possible. RESULTSHistopathological examination showed the tumour to be a melanoma predominantly of spindle cell type. Postoperative complications included a dense vitreous haemorrhage, which cleared spontaneously, and raised intraocular pressure, controlled with latanoprost. Seven years after brachytherapy, the vision was 6/5 and the thickness of the residual tumour was 2.5 mm. Nine years after treatment, there was no evidence of any intra- or extraocular seeding or distant metastases. CONCLUSIONSCore endoresection of a ciliochoroidal melanoma may reduce tumour thickness enough to allow subsequent ruthenium plaque radiotherapy.
INTRODUCTIONMetastatic tumors are the most common intraocular malignancies in adults. Anterior segment metastases account for about 7.2-14.1% of all intraocular metastatic tumors with those to the ...iris representing 3.6-7.8% of the cases. Breast and lung are the most frequent primary sites of metastasizing cancer. The aim of this study is to present the case of a 43-year-old patient with a rare small-cell lung carcinoma metastasis to the iris. CASE REPORTA patient with small-cell lung carcinoma and metastases in the brain who had been treated with chemo- and radiotherapy attended an outpatient clinic because of redness of her left eye. Based on the ophthalmological examination, a diagnosis of numerous metastatic tumors to the iris was made and the patient was referred for re-chemotherapy. Complete regression of the iris lesions was observed after 5 months but unfortunately two months later the patient died, due to progression of her systemic disease. DISCUSSIONAmong lung cancers, adenocarcinomas are much more likely to produce distant metastases to the iris than small-cell carcinomas 4. More than 50% of patients with small-cell lung carcinoma have metastases in the brain. The survival rate in cases of lung cancer with eye involvement is poor and approximates to 7 months. However, since there is a strong probability of angle involvement and subsequent secondary glaucoma, the early onset of treatment can improve the patient's quality of life during the terminal phase of the disease.
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