Clinicopathological analysis of 110 ocular malignant melanoma

Abstract

Background Ocular melanoma is a malignant tumor with a poor prognosis.To study its mode of pathogenesis and development is helpful for early diagnosis and treatment and improving prognosis. Objective This study was to analyze the location and pathological types of ocular melanoma,and explore the relationship of pathological types with prognosis of ocular malignant melanoma. Methods 110 clinical data and specimens of ocular melanoma were collected at West China Hospital,China.The specimens were examined by hematoxylin & eosin staining,immunochemistry and studying their ultrastructure.The growth location,histological classification,and their relationship with prognosis were analyzed and discussed.The clinicopathological records of the 1 l0 cases with ocular region malignant melanoma treated from January 1980 to December 2007 were analyzed. Results The primary locations of the tumors with respect to the tissue type were:66 cases in the uvea (60.00％ ),27 cases in the ocular surface tissue (24.55％),8 cases in the secondary lesion of orbit cavity (7.27％),7 cases on the eyelid skin (6.36％),and 2 cases in the lacrimal sac ( 1.82％ ).The neoplasm was classified according to pathological types:spindle-cell A type in 31 cases (28.18％ ),spindle-cell B type in 31 cases (28.18％),mixed-cell type in 25 cases (22.73％),epithelioid-cell type in 17 cases ( 15.46％ ) and other type in 6 cases (5.45％).The notability of diffusion or recurrence rate of the 5 pathological types showed statistical significance (x2 =14.463,P =0.006 ),and the rank in decending order was:other type,epithelioid-cell type,mixed-cell type,spindle-cell B type and spindle-cell A type.The clinical manifestations of ocular melanoma were dependent upon the lesion position without specificity.Conclusions The majority of the ocular malignant melanoma appears in the uvea and ocular surface tissue,and its common pathological types were spindle-cell type followed by mixed-cell type,epithelioid-cell type and other type.The highest recurrence rate is in other type of ocular malignant melanoma.Ophthalmologist should be aware of the clinical manifestation of ocular malignant melanoma. Key words: Neoplasm; Ophthalmology; Malignant melanoma/symptom, classification, prognosis; Pathology/immunochemistry, ultrastructure