Enucleated globes with choroidal melanoma: A retrospective histopathological study and correlation with cytogenetic profile in 2 eye centers

Hind M Alkatan,Abdullah Aoun Al Qahtani,Azza My Maktabi

doi:10.1016/j.amsu.2020.05.003

Abstract

BackgroundUveal melanoma is the commonest intraocular malignant tumor in adults and the choroid is the commonest involved location. It is more prevalent in Caucasians; however, the demographics are widely variable based on ethnicity. Histopathological features have been correlated to the cytogenetic profile, which we intend to report through the study of enucleated eyes with choroidal melanoma (CM). Materials and MethodsA retrospective review of 28 enucleated globes with CM in 2 tertiary eye centers (January 2000-December 2017). The tumors were histopathologically classified based on the 8th edition of the American Joint Committee on Cancer (AJCC). The histopathological risk factors and the AJCC classifications were correlated with Fluorescence in situ hybridization (FISH) for chromosomes 3 and 8 available results in 18/28 eyes. ResultsWe have included 28 patients with a mean age of 56 years, 13 males (46.4%) and 15 females (53.6%). None had lymph node involvement or metastatic disease. The tumor size was categorized as 3 and 4 in 68% of eyes. Half tumors were of spindle cell type and were associated with absent cytogenetic abnormality in chromosomes 3 and 8 (P=0.005). Closed vascular loops presence was significantly associated with abnormal chromosomes 3 and 8 (P=0.027). ConclusionPatients in our area presented late with larger tumor size. The spindle cell CM was the commonest and correlated with negative FISH results, while the presence of closed vascular loops was a risk factor for abnormal FISH results hence expected worse prognosis. AJCC classification did not correlate well with our FISH results.

Highlights

Uveal melanoma (UM) is the commonest primary intraocular malignancy in the adult population, affecting 4 to 7 per million in the United States per year [1]
Our goal in this study is to evaluate the demographic characteristics of uveal melanoma in our geographic part of the world and to correlate the histopathological features to the limited available cytogenetic analysis for loss of chromosome 3 and gain of chromosome 8
The study was approved by the Institutional Review Board and Human Ethics Committee (IRB/HEC) with expedited approval as a retrospective study at King Khaled Eye Specialist Hospital (KKESH) with a form of a collaborative agreement with King Abdulaziz University Hospital (KAUH), Riyadh, Saudi Arabia

Summary

Introduction

Uveal melanoma (UM) is the commonest primary intraocular malignancy in the adult population, affecting 4 to 7 per million in the United States per year [1]. Histopathological bad prognostic indicators have been identified and extensively studied These include large basal tumor diameter, epithelioid cell type, high mitotic activity, CB involvement, and the presence of closed extravascular matrix loop [10]. Uveal melanoma is the commonest intraocular malignant tumor in adults and the choroid is the commonest involved location. It is more prevalent in Caucasians; the demographics are widely variable based on ethnicity. Histopathological features have been correlated to the cytogenetic profile, which we intend to report through the study of enucleated eyes with choroidal melanoma (CM). The histopathological risk factors and the AJCC classifications were correlated with Fluorescence in situ hybridization (FISH) for chromosomes 3 and 8 available results in 18/28 eyes. AJCC classification did not correlate well with our FISH results

Methods

Results

Discussion

Conclusion