Biopsy Cases Research Articles

Respiratory Failure, Pulmonary Hypertension, and Critically Ill chILD - A Case for Early Lung Biopsy

Respiratory Failure, Pulmonary Hypertension, and Critically Ill chILD - A Case for Early Lung Biopsy

Predicting frequency distributions of biopsied genotypes by their discrete cohort size using the binomial theorem

Predicting frequency distributions of biopsied genotypes by their discrete cohort size using the binomial theorem

Assessment of p53 in Endometrial Carcinoma Biopsy and Corresponding Hysterectomy Cases in a Real-World Setting: Which Cases Need Molecular Work-Up?

Over 420,242 women were diagnosed with uterine cancer worldwide in 2022 [...].

Morphometric study of proximal tubular cell mitochondria using TEM images in renal diseases

ABSTRACT The kidney is rich in mitochondria, and any alterations or damage to tubular cell mitochondria play an important role in renal metabolic activities and the pathogenesis of various kidney diseases. Quantitative analysis of mitochondrial concentration, size, and shape is essential for understanding mitochondrial biology in renal disorders. This study assessed mitochondrial morphometric parameters of the proximal convoluted tubular cell adjacent to the glomerulus in different renal disorders and investigated how they correlated with serum creatinine. A total of 65 kidney biopsy cases received by the transmission electron microscope (TEM) laboratory for diagnosis were included in the study. TEM images of glutaraldehyde-osmium tetroxide fixed epoxy-resin embedded 70 nm thick sections were used for the evaluation of (i) minor axis(MinX) (ii) major axis(MajX) (iii) Area, (iv)Perimeter, (v) Aspect ratio and (vi) Roundness of mitochondria in renal tubular cells using QuPath software. Mitochondrial density (MDensity), % of mitochondrial space (MSpace), and mitochondrial surface density (MSDensity) in the cytoplasm of tubular space were estimated for each sample. Serum creatinine showed good negative correlations with MSpace and MSDensity, and elongation of mitochondria was more in renal disorder in comparison to normal histology, which indicated the variation of mitochondrial concentration and shape in proximal tubular cells could be important features in the renal function disorder.

Abstract 1912: Immune and molecular markers in benign breast disease predict risk of node-positive breast cancer

Abstract Background: Breast cancer (BC) remains a leading health concern worldwide and is often undetected until it metastasizes, limiting treatment options and worsening prognosis. Early detection of molecular and immune markers in benign breast disease (BBD) could identify women at elevated risk of developing invasive, node-positive BC, enabling targeted surveillance and prevention efforts. Building on this premise, we investigated the immune and molecular landscape of BBD biopsies preceding BC development to enhance risk stratification and inform preventive strategies. Methods: Utilizing the Mayo Clinic BBD cohort, we conducted a case-control study comparing women who developed node-positive BC following their BBD biopsy (cases; n=8) to those who remained cancer-free (controls; n=11), matched on patient age and biopsy date. Differential gene expression was assessed using the NanoString nCounter system to identify differentially expressed genes between cases and controls. We developed a multiplex immunofluorescence (MxIF) approach using the Opal system by Akoya Biosciences for comprehensive marker detection in formalin-fixed, paraffin-embedded (FFPE) tissue samples. Digitized images were segmented for cell phenotyping, and spatial relationships of immune cells were analyzed and compared between cases and controls. Results: Our findings revealed significantly increased expression levels of immunosuppressive genes in the case group, including CD48, CD84, IL-32, and LAIR1. Immunohistochemical analyses showed that controls exhibited higher frequencies of CD68+ (macrophages), CD11c+ (M1 macrophages), and CD206+ (M2 macrophages) cells compared to cases. Notably, controls had a significant increase in CD68+CD11c+ cells, indicative of a pro-inflammatory, antitumorigenic M1 macrophage polarization. Furthermore, our MxIF analyses provided novel insights into spatial biomarker localization, enhancing prognostic accuracy. Conclusions: The decreased numbers of immune cells and increased expression of immunosuppressive genes in BBD biopsies may be associated with an elevated risk of developing axillary node-positive BC. These findings emphasize the importance of dissecting molecular and immune interactions in BBD for risk assessment. Our results have the potential to improve individualized risk stratification, leading to more targeted surveillance and informed screening. This research not only contributes to our understanding of BC pathogenesis but also opens avenues for developing novel preventive strategies, potentially reducing BC incidence and mortality through early intervention. Citation Format: Matilde Rossi, Nicole Cruz-Reyes, Trista Navarro, Melody L. Stallings-Mann, Bryan M. McCauley, Robert A. Vierkant, Stacey J. Winham, Mark E. Sherman, Amy C. Degnim, Derek C. Radisky. Immune and molecular markers in benign breast disease predict risk of node-positive breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 1912.

Radiation in the Bronchoscopy Suite: One Center's Experience With Navigational Bronchoscopy and a Review of the Literature.

This study aimed to quantify radiation doses during navigational bronchoscopy procedures, comparing them with reported cohorts and evaluating the LungVision (Body Vision Medical Inc.) system's efficacy in dose reduction. This retrospective observational study included 52 consecutive navigational bronchoscopy cases, categorized into 4 imaging groups based on the C-arm: Cios Spin (Siemens Healthineers), or OEC 9900 (GE HealthCare); and the 3D tomographic imaging algorithm: Cios Spin's onboard imaging, or LungVision's AI-driven imaging. Patient and lesion data, outcomes, and radiation indices were collected. Existing literature on 3D image guidance for bronchoscopic lung nodules was reviewed to compare reported radiation doses. Combining LungVision with Cios Spin significantly reduced radiation dose in all cases compared with using Cios Spin alone: Cumulative air kerma (Ka,r) reduced from 238.7 to 119.1mGy (P=0.03), and air kerma-area product (KAP) decreased from 28.19 to 15.09Gy·cm2 (P=0.03). For biopsy cases, LungVision led to notable dose reductions: Ka,r of 279 to 129.1mGy, and KAP of 30.70 to 16.27Gy·cm2. LungVision notably reduced radiation indices in 7 paired spins, isolating the 3D imaging algorithm as the sole variable with the same Cios Spin C-arm. A literature review provides additional context on radiation for bronchoscopic biopsies. Following the "as low as reasonably achievable" (ALARA) principle minimizes ionizing radiation exposure, benefiting patients and operators. Physicians should compare baseline radiation levels with the literature and adopt dose-reduction techniques. LungVision's lower dose indices render it effective for real-time 3D imaging during navigational bronchoscopy while reducing radiation dose.

P126 An analysis of major histocompatibility complex class II antigen expression in the muscle biopsies of patients with inclusion body myositis

Abstract Background/Aims Inclusion body myositis (IBM) is the most common acquired muscle disease in people aged over 50 years. It belongs to a heterogeneous group of diseases known as idiopathic inflammatory myopathies (IIM). Finding major histocompatibility complex class I (MHC-I) expression on the sarcolemmal membrane forms part of the diagnostic criteria for IBM. However, sarcolemmal MHC-I expression is also very common in other types of IIM, and is also seen in non-inflammatory myopathies. Recent studies have shown that major histocompatibility complex class II (MHC-II) expression may be more specific to IBM and could therefore facilitate earlier diagnosis. We undertook a further study to investigate these preliminary findings. Methods We investigated 42 muscle biopsy cases (12 IBM; 11 Other IIM; 19 Other myopathies) from the Northern Care Alliance NHS Foundation Trust and analysed the sensitivity and specificity of MHC-I and MHC-II immunostaining for the diagnosis of IBM. We correlated the intensity of MHC-II and MHC-I expression and quantitative results with the extent of lymphocytic infiltration, staining patterns, and clinical parameters including patient age, sex, and immunosuppressive treatment. Results Our findings showed positive MHC-I immunostaining exhibits high sensitivity (1.000) but low specificity (0.182) in IBM diagnostic assessments. In contrast, MHC-II expression is more specific (0.727) for IBM than MHC-I expression, which supported the use of immunostaining for MHC-II as a useful adjunctive diagnostic test in IBM. In addition, we found that the intensity of MHC-I and MHC-II expression in IIM (5 Other IIM and 1 IBM) may have been affected by prior immunosuppressive therapy. Conclusion We recommend that MHC-II immunostaining of muscle biopsies should be included for adults undergoing assessment for myopathy, especially where IBM is considered as a differential in order to achieve a more accurate diagnostic assessment. In the present study, immunosuppressive therapy did not revert positive MHC-I or MHC-II to negative but may have reduced the intensity of expression to some extent; larger sample sizes and more detailed studies are needed to determine whether biomarkers in IIMs are altered as a result of immunosuppressive therapy and the frequency and extent of such alterations. Disclosure X. Wang: None. H. Chinoy: None. F. Roncaroli: None. J. Lilleker: None.

Epidemiological analysis of mammary tumors in female dogs in Japan: A study based on Kyushu-Okinawa region.

Epidemiological analysis of mammary tumors in female dogs in Japan: A study based on Kyushu-Okinawa region.

MRI-guided biopsy reduces biochemical recurrence in prostate cancer patients undergoing radiation therapy: a single-center study from Thailand

Accurate diagnosis of significant prostate cancer (PCa) is essential for effective treatment. Multiparametric magnetic resonance imaging (mpMRI) is increasingly used for lesion detection and biopsy guidance, but its impact on outcomes following radiotherapy remains uncertain. This study assesses the effect of MRI-guided biopsy on biochemical recurrence (BCR) following definitive external beam radiotherapy (EBRT). This single-center, retrospective review included 102 patients with localized PCa who received primary EBRT between 2018 and 2021. The MRI-guided biopsy group underwent both targeted and systematic biopsies, while the non-MRI-guided biopsy group underwent systematic biopsy alone. All patients underwent pre-treatment MRI (pre-RT MRI). Kaplan-Meier analysis compared BCR-free survival between the MRI-guided and non-MRI-guided biopsy groups. Among the 102 patients, 57 underwent MRI-guided biopsy, with 52.9% classified as intermediate-risk. The median follow-up period was 57.2 months. The proportion of very-high-risk patients was significantly greater in the non-MRI-guided biopsy group (24.4% vs. 3.5%, p = 0.01). Seventeen patients in the non-guided biopsy group were staged as T3 with the assistance of the pre-RT MRI. Despite the use of pre-RT MRI in all non-MRI-guided biopsy cases, four patients experienced BCR, whereas no BCR was observed in the MRI-guided biopsy group. The MRI-guided biopsy group demonstrated superior BCR-free survival (p < 0.01) across both intermediate- and higher-risk groups. MRI-guided biopsy was associated with a reduced risk of BCR following definitive EBRT, particularly in intermediate-risk patients. In contrast, systematic random biopsies, even when combined with pre-RT MRI, were linked to poorer intermediate oncologic outcomes.

Prostate cancer detection with transrectal in-bore MRI biopsies: impact of prostate volume and lesion features

ObjectivesTo systematically analyze the diagnostic outcome of transrectal in-bore MRI-guided biopsies as a function of prostate volume and lesion features.MethodsThis single-center study retrospectively included 184 consecutive patients with transrectal in-bore MRI biopsies and histological analysis after multiparametric MRI diagnostics of at least one PI-RADS ≥ 3 lesion. Diagnostic and biopsy MRI data were analyzed for a number of patient and imaging features, specifically prostate volume, lesion size, lesion location (longitudinal, sagittal and segmental) and lesion depth. Features were then compared for statistically significant differences in the cancer detection rate (CDR) of clinically significant (cs-PCa) and any prostate cancer (any-PCa) using categorical and continuous variables.ResultsA total of 201 lesions were biopsied detecting cs-PCa in 26% and any-PCa in 68%, respectively. In subgroup analyses of all features, the CDR of cs-PCa differed significantly between ranges of lesion size only (p < 0.001, largest for large lesions). In multivariable analysis, however, only PI-RADS score and PSA showed a significant association with a higher risk of cs-PCa.ConclusionsThe cancer detection rates of transrectal in-bore MRI-guided biopsies did not vary significantly for prostate volume, lesion size or lesion location. This suggests that the diagnostic performance of such an approach is not necessarily compromised for challenging biopsy settings like large glands, small lesions or eccentric locations. A translation of these findings to other cohorts might be limited by the low detection rate for clinically significant cancer.Critical relevance statementThis systematic analysis indicates that the diagnostic performance of transrectal in-bore biopsies might not be substantially impaired by patient-specific factors like prostate volume, lesion size, and lesion location, making it a viable option for challenging biopsy cases as well.Key PointsThe impact of prostate and lesion features on in-bore MRI biopsy performance is controversial.Neither prostate volume, lesion size, nor location showed significant impact on cancer detection.In-bore biopsy does not seem to be limited by challenging sampling geometries.Graphical

Unusual Systemic Conditions in a Patient with Giant Cell Arteritis.

Giant cell arteritis is a systemic vasculitis that causes inflammation in medium and large-sized blood vessels. The condition can lead to irreversible blindness if not recognized and treated promptly with high-dose steroids. Clinical manifestations typically include headache, jaw pain, fever, and fatigue. However, unusual manifestations of the disease have been reported, including pulmonary nodules, uveitis, pericarditis, and stroke. We report a case of biopsy confirmed giant cell arteritis in a patient found to have renal cell carcinoma, exhibiting these unusual manifestations simultaneously. This case report demonstrates the atypical presentation that giant cell arteritis may have and the importance of having a high clinical suspicion for the condition.

Navigating the enigma of bone marrow granulomas: A case series exploration

Introduction: Granulomatous diseases of marrow can result from a varied group of disorders ranging from infectious diseases to hematological malignancies. Finding granuloma in bone marrow biopsy is a rare finding. Detection of granulomatous disease is possible on Bone marrow biopsy and sometimes it changes the treatment modality. Aims and Objectives: To study incidence and etiologies of granulomatous diseases of marrow. Materials and Methods: This was a retrospective study conducted in Department of Pathology, M.K.C.G. Medical College and Hospital, Berhampur. Bone marrow biopsy performed in the period of 1st January 2021 to 31st December 2022were reviewed along with medical records of these patients. Results: We reviewed 185 cases of Bone marrow biopsy confirming presence of granuloma in ten patients. The age of the patients varied from 5 years to 55 years. Out of the 10 cases seven (70%) had history of fever, two (20%) with history of pain in abdomen and loss of appetite and (10%) one with weakness. Eight (80%) out of the ten cases had organomegaly. CBC and peripheral smear evaluation of all the cases were done and the finding was pancytopenia in six (60%) cases followed by bicytopenia in four (40%). Seven out of the 10 cases were diagnosed as case of Tuberculosis, one as Hogdkin’s Lymphoma one as Sarcoidosis in Bone marrow trephine biopsy. Despite of thorough investigations no definite etiology was detected in one case. Conclusion: Bone marrow trephine biopsy is very helpful in finding out Granuloma which is though a non-specific finding may narrow down the diagnosis to various possible differentials.

Comparison of two visual localization biopsy methods for suspicious breast lesions under mammography: a multicenter cohort study.

Compared with traditional mammography, digital breast tomosynthesis (DBT) increases the detection of breast lesions by reducing the overlapping masking effect of glands through multi-angle exposures of a rotating X-ray tube. Breast biopsy under the guidance of mammography can effectively diagnose breast lesions. The main methods of mammography-guided biopsy include wire positioning, core needle biopsy (CNB), and vacuum-assisted breast biopsy (VABB). Currently, it is mainly guided by stereotactic or DBT-guided localization. In this study, we conducted a retrospective study to compare the clinical efficiency and performance of DBT-guided and prone stereotactic (PS)-guided breast lesion biopsies. We performed a retrospective analysis of 406 patients who underwent mammogram-guided biopsies from three hospitals between August 2020 and August 2024. The cohort comprised 234 cases of DBT-guided biopsies and 172 cases of PS-guided biopsies. The DBT-guided biopsy methods included wire positioning, CNB, and VABB. The PS-guided biopsy methods included wire positioning and CNB. Statistical analyses utilized the Chi-squared or Mann-Whitney U tests to compare the effectiveness of biopsy methods acquired under DBT guidance and PS guidance. In wire positioning and CNB, both the DBT-guided group and PS-guided group had higher biopsy success rates (100% vs. 92.6%, 100% vs. 96.2%), with no statistically significant difference (P=0.154 and P=0.127, respectively). Compared to the PS-guided group, the DBT-guided group had shorter total intervention (P<0.001) and lesion targeting time (P<0.001), less time to obtain the first effective positioning images (P<0.001), and fewer exposure times (P<0.001). The incidence of complications was lower in both DBT-guided and PS-guided groups, with no statistically significant difference (P=0.851 and 0.861, respectively). In addition, we successfully performed 69 cases of DBT-guided VABB. Compared with wire positioning and CNB under DBT guidance, this method also had shorter total intervention (19.49±4.75 minutes) and lesion targeting time (5.00, 7.00 minutes), and reduced exposure time (4.00, 5.00 exposures). DBT-guided biopsies outperformed PS-guided biopsies in clinical efficiency, achieving quicker procedures and requiring fewer exposures while enabling the biopsy of a broader range of non-calcified breast lesions.

Dissociation in hepatic vein pressure gradient, liver stiffness measurement and complications in histological subtypes of porto-sinusoidal vascular disease

Background and aimsPortosinusoidal vascular disease (PSVD) is a broad term encompassing varied histological patterns with changes in portal tracts and sinusoids without cirrhosis. We aimed to assess whether there is...

Pneumothorax as Complication of CT Guided Lung Biopsy: Frequency, Severity and Assessment of Risk Factors

Background: CT-guided lung biopsy is routinely performed minimally invasive procedure. Imaging findings in the lung can have a broad differential diagnosis; therefore, it is indicated for definitive determination of pulmonary nodules or masses. Post-biopsy complications are common with most of them manageable in daycare. As pneumothorax is the most common complication, frequency and severity of pneumothorax with assessment of risk factors and follow-up for resolution is necessary. Methods: A prospective evaluation of 123 biopsies with automated coaxial biopsy of 18 gauge was done. Post-biopsy pneumothorax was evaluated for its incidence and resolution. The studied risk factors were; patient age, sex, lesion location, lesion size, shortest pleural lesion depth, traversed lung parenchymal distance, presence of emphysema, fissure penetration, needle thoracic wall angle, and lesion characteristics. Results: Reported immediate post-procedural pneumothorax was 22% with 19% of mild, 4% of moderate and 2.4% of severe cases. 51.9% of cases showed resolution within 24 hours. The intervention was required in only 4.8% of biopsy cases. A significant p - value of pneumothorax with the nodule depth increased traversed lung parenchymal distance, acute needle angle, fissure puncture, and presence of emphysema was seen. Emphysema was an independent variable in pneumothorax in multivariate analysis. Conclusion: Pneumothorax is an unamenable consequence of CT-guided lung biopsy and a cautious approach should be kept in view of the variables that are associated with it to reduce its incidence and severity in patients.

Prediction of Prostate Cancer From Routine Laboratory Markers With Automated Machine Learning.

In this study, we attempted to select the optimum cases for a prostate biopsy based on routine laboratory test results in addition to prostate-specific antigen (PSA) blood test using H2O automated machine learning (AutoML) software, which includes many common machine learning algorithms. The study included 737 patients (46-88 years old). Routine laboratory measurements were used to train machine learning models using H2O AutoML. We created a model that classifies prostate biopsy results as malignant or benign. The performance of the best model was evaluated using the area under the receiver operating characteristic curve (AUC), log-loss metric, F1 score, positive predictive value (PPV), negative predictive value (NPV), sensitivity, and specificity. The model's performance was evaluated through the SHapley Additive exPlanations (SHAP) analysis feature-based interpretation method applied to comprehend the machine learning model. The gradient boosting machine model was the most successful. The best result was obtained in the model with 11 parameters, including PSA, free PSA, free PSA to PSA, hemoglobin, neutrophils, platelets, neutrophil-to-lymphocyte ratio (NLR), glucose, platelet-to-lymphocyte ratio (PLR), lymphocytes, and age. The AUC of this model was 0.72, the specificity was 0.84, the PPV was 0.65, the NPV was 0.69, and the accuracy was 0.68. Our results suggest that adding only routine laboratory parameters to the PSA test and developing machine learning algorithms can help reduce the number of unnecessary prostate biopsies without overlooking the diagnosis of PCa.

Fine-Needle Aspiration Biopsy of Adrenal Gland Lesions: The Roles of Image Guidance, Rapid On-Site Evaluation and Additional Tissue Sampling.

An accurate fine-needle aspiration (FNA) diagnosis of adrenal lesions may be challenging. This study was to investigate roles of imaging guidance, rapid on-site evaluation (ROSE) and additional tissue sampling in FNA diagnosis of adrenal lesions. Adrenal FNA cases were retrieved from pathology archive. Patients' demographics, lesion size and location, imaging guidance methods, cytologic diagnoses and histopathologic diagnoses were reviewed and analysed. The study cohort included 72 cases of left (86%) and right (14%) adrenal lesions. Endoscopic ultrasound (EUS) and computed tomography (CT) were used in 47 (65%) and 25 (35%) cases, respectively. Left adrenal lesions were sampled mostly by EUS-FNA (73%), whereas right adrenal lesions by CT-guided FNA (80%). There were no differences between the EUS-FNA and CT-FNA groups in terms of non-diagnostic rate and cytologic diagnostic categories. The non-diagnostic rate and cytologic diagnostic categories were the same between ROSE and non-ROSE groups. In a subset of 18 cases with concurrent core tissue biopsy, a definite diagnosis was rendered in all biopsy cases including three cases with a non-diagnostic or indeterminate cytology diagnosis. Our study demonstrates that FNA has great efficacy for evaluation of adrenal lesions, either via EUS or CT guidance. Incorporation of ROSE evaluation into FNA procedure does not directly affect the performance of FNA biopsy but may help direct additional tissue sampling to salvage the cases with a non-diagnostic or indeterminate cytology diagnosis, increasing diagnostic yield.

Posterior Fossa Stereotactic Biopsy with Leksell Vantage Frame-Case Series and Review of Literature.

Background: Stereotactic biopsy of posterior fossa lesions, which are often inoperable, enables a safe trajectory and provides tissue samples for accurate diagnosis, which is crucial for correct treatment since the latest World Health Organization Classification of Tumors of the Central Nervous System from 2021 places immense emphasis on molecular diagnostics. Stereotactic biopsy using the Leksell Vantage headframe is, due to its rigid design, extremely accurate, but stiffer, making the procedure more challenging and the learning curve steeper. Methods: This retrospective analysis demonstrates the introduction of the new Leksell Vantage headframe in day-to-day practice at the University Medical Center in Maribor, Slovenia, in demanding procedures of posterior fossa biopsies, and also provides a review of the literature available on the topic with emphasis on the technical aspect of posterior fossa biopsy using the Leksell Vantage headframe in adults. Results: In the observed series of three patients with posterior fossa lesions, all biopsies were representative, despite tissue samples being small, providing conclusive histopathologic reports (glioblastoma, rosette-forming glioneuronal tumor and metastasis of melanoma) with additional molecular diagnostics. After the initial biopsy case, the preoperative planning times and procedure times were shortened as we learnt about the importance of a tailored approach from the first case. In all cases, the biopsy was performed under local anesthesia with patients being awake throughout surgery. Conclusions: The rigid Leksell Vantage headframe makes access to the posterior fossa tougher when compared to its predecessors. However, the procedure is very accurate but requires precise preoperative planning and a customized approach when placing the headframe.

Sentinel lymph node biopsy in a case of conjunctival melanoma

Aims/Purpose: To present the first case of a sentinel lymph node biopsy for ocular melanoma in our hospital.Methods: We present the clinical case of a patient treated in our unit for conjunctival melanoma in the right eye. An excision of the conjunctival lesion with safety margins was performed, followed by the application of mitomycin C, cryotherapy, and placement of an amniotic membrane. The histopathological diagnosis confirmed an invasive nodular melanoma pT2aNxMx Breslow 1.5 mm with clear margins. Subsequently, three weekly cycles of 0.04% mitomycin C eye drops were administered. The extension study ruled out disease dissemination.Results: The case was presented to the Melanoma Committee, where it was decided to perform a sentinel lymph node biopsy. The procedure was carried out without evidence of metastasis in the analyzed lymph node (0/1), confirmed by histological examination with Hematoxylin‐eosin and immunohistochemistry with HMB45 and SOX10. This is the first case of a sentinel lymph node biopsy for ocular melanoma in our hospital. Thanks to close collaboration between the Ophthalmology and Radiology departments, the procedure was performed correctly.Currently, the patient continues with successive follow‐ups by Ophthalmology, showing good evolution. This case highlights the importance of interdisciplinary collaboration in the management of conjunctival melanoma and the efficacy of adjuvant treatments, such as mitomycin C, in preventing local recurrencesConclusions: Current literature supports the performance of sentinel lymph node biopsy in cases of conjunctival melanoma due to its ability to detect micrometastases and guide therapeutic management, thus improving patient prognosis. It is a valuable tool in the accurate staging of conjunctival melanoma, allowing for earlier intervention in case of lymphatic dissemination and potentially improving survival rates.

Sentinel lymph node biopsy in a case of conjunctival melanoma

Aims/Purpose: To present the first case of a sentinel lymph node biopsy for ocular melanoma in our hospital.Methods: We present the clinical case of a patient treated in our unit for conjunctival melanoma in the right eye. An excision of the conjunctival lesion with safety margins was performed, followed by the application of mitomycin C, cryotherapy, and placement of an amniotic membrane. The histopathological diagnosis confirmed an invasive nodular melanoma pT2aNxMx Breslow 1.5 mm with clear margins. Subsequently, three weekly cycles of 0.04% mitomycin C eye drops were administered. The extension study ruled out disease dissemination.Results: The case was presented to the Melanoma Committee, where it was decided to perform a sentinel lymph node biopsy. The procedure was carried out without evidence of metastasis in the analyzed lymph node (0/1), confirmed by histological examination with Hematoxylin‐eosin and immunohistochemistry with HMB45 and SOX10. This is the first case of a sentinel lymph node biopsy for ocular melanoma in our hospital. Thanks to close collaboration between the Ophthalmology and Radiology departments, the procedure was performed correctly.Currently, the patient continues with successive follow‐ups by Ophthalmology, showing good evolution. This case highlights the importance of interdisciplinary collaboration in the management of conjunctival melanoma and the efficacy of adjuvant treatments, such as mitomycin C, in preventing local recurrencesConclusions: Current literature supports the performance of sentinel lymph node biopsy in cases of conjunctival melanoma due to its ability to detect micrometastases and guide therapeutic management, thus improving patient prognosis. It is a valuable tool in the accurate staging of conjunctival melanoma, allowing for earlier intervention in case of lymphatic dissemination and potentially improving survival rates.