Cases Of Ciliary Body Melanoma Research Articles

Ciliary body melanoma: A case report and review of literature

Malignant melanoma of ciliary body is rare in Indian -Asian population. Its incidence is about 0.02-0.06% in India. Since it is in a hidden location behind the iris, patients of ciliary body melanoma usually present late in advanced stage. We intend to report an asymptomatic case of ciliary body melanoma identified during the pre-operative cataract assessment of a patient at a tertiary care eye center of North India. It emphasizes the importance of detailed slit lamp examination and fundus examination beforesurgery in camp cases. Early diagnosis is very important as this tumor has very poor prognosis. Keywords: Ciliary body tumor, Malignant melanoma, Poor prognosis, Indian population.

Histopathological analysis of the correlation between uveal melanomas and retinal tissue

AIM: To analyze the impacts of the shape of uveal melanoma on retinal structure. METHODS: Histopathological sections and clinical data from patients with uveal melanoma were retrospectively observed and analyzed, and key indicators including the tumor’s shape, size, height-to-base ratio, retinal thinning and retinal invasion were analyzed. RESULTS: The study included 102 patients (102 eyes) with a mean age of 45.6±12.4y, with 76 (75%) uveal melanomas showing the spindle cell type, 6 (6%) showing the epitheloid cell type, 16 (16%) showing the mixed cell type and 4 (4%) showing predominantly other cell types. Differentiated by tumor locations: 3 cases of ciliary body melanoma (2.9%), 28 cases of ciliary body and choroid melanoma (27.5%), 71 cases of choroid melanoma (69.6%). Retinal thinning was detected in 43 (43%) eyes and retinal invasion by the tumor cells in 86 (84%) eyes. Maximal tumor height ranged between 1.2 and 15.6 (mean: 8.3±3.6) mm, and mean maximal tumor base diameter was 17.3±6.5 (range: 4.8-31.2) mm. Mean R-value as ratio of tumor peak height to maximal tumor base diameter was 0.53±0.32. Mean R-value was significantly higher in the group with retinal thinning (n=43) than in the group without retinal thinning (n=59; 0.69±0.31 vs 0.42±0.27; P<0.01). R-value was slightly, however statistically not significantly (P=0.09) higher in the group with retinal tumor invasion (n=86) than without retinal tumor invasion (n=16) (0.56±0.33 vs 0.41±0.25). CONCLUSION: A high R-value indicating a prominent tumor is associated with tissue thinning in the adjacent retina, and marginally significantly with intra-retinal tumor cell invasion. Shape of uveal melanomas’s corss section is of importance for the secondary involvement of the adjacent retina.

Unusual presentation of ciliary body melanoma - a case report

Background: Ciliary body melanoma rarely grows transclerally by direct extension and can metastasize locally into the orbit or conjunctiva. Objective: To report a case of ciliary body melanoma presenting clinically as a mass in the lacrimal gland region. Case: A 40-year-old female presented to the ophthalmic out-patient department with the complaint of a swelling in the right upper and outer lid region for 4 years. Ocular examination revealed a phthisical right eye. A firm, non-tender mass was palpable in the temporal quadrant of the right supraorbital region. Ultrasonography showed retinal detachment of the right eye. The CT-scan of the orbit was reportedly suggestive of a right lacrimal gland mass. Superolateral transperiosteal orbitotomy was planned for excision of the lacrimal gland mass. Intraoperatively, a well defined mass arising from the supero-temporal region of the right globe was noticed. The procedure was converted to enucleation of the right eye. Histopathological examination of the mass showed features of ciliary body melanoma. Conclusion: Extrascleral extension of ciliary body melanoma can present as a mass in the lacrimal gland region. DOI: http://dx.doi.org/10.3126/hren.v11i3.9657 Health Renaissance 2013;11(3):287-289

Mélanome du corps ciliaire révélé par une uvéite chez un sujet mélanoderme, à propos d’un cas et revue de la littérature

The incidence of uveal melanoma, in particular that of the ciliary body, is very low in black people, including West Indians. When symptomatic, it manifests as decreased or impaired visual acuity and seldom, if ever, pain. We report a case of ciliary body melanoma that is of scientific interest for two reasons: 1) a West Indian melanoderm patient being affected, 2) presentation as a recurrent uveitis with a transient increase of intraocular pressure, and without any decline in visual acuity. We recommend that in any case of uveitis, black patients included, a ciliary body tumor should always be excluded by pupillary dilation.

Ciliary body melanoma with partial deletion of chromosome 3 detected with multiplex ligation-dependent probe amplification

The management of a patient with a small, pigmented ciliary body tumour is controversial, the various options including observation, radiotherapy, fine needle aspiration biopsy and excision biopsy. We report a case of ciliary body melanoma with partial deletion of chromosome 3, which was missed with fluorescence in situ hybridization (FISH) but detected with multiplex ligation-dependent probe amplification (MLPA). A 23-year-old woman underwent an excision biopsy for a 4.5 mm by 3.9 mm by 2.0 mm ciliary body tumour, which was assessed by histology, immunohistochemistry, FISH and MLPA. Histology showed the tumour to a melanoma of mixed cell type. FISH with a centromeric probe indicated that the tumour was of disomy 3 type with a good prognosis; however, MLPA revealed a partial deletion of the long arm of chromosome 3. This case highlights the limitations of FISH, and demonstrates the value of MLPA in testing multiple chromosomal loci of prognostic significance. To our knowledge this is the first reported case of ciliary body melanoma assessed by MLPA.

Ciliary body melanoma masquerading as chronic uveitis

PURPOSE: To report a case of ciliary body melanoma that masqueraded as chronic uveitis. METHODS: A patient experienced persistent unilateral panuveitis and elevated intraocular pressure. Inflammation and pressure worsened after cataract extraction and lens implantation. Diagnostic vitrectomy was non-revealing. RESULTS: Repeat vitrectomy and lens implant removal revealed a ciliary body mass, suggestive of melanoma. Ultrasonography and clinical evaluation by the retinal oncologists supported this diagnosis. The uveitis persisted despite aggressive medical treatments, including methotrexate. Proton beam irradiation of the melanoma led to resolution of uveitis and restoration of normal intraocular pressure. CONCLUSIONS: Ciliary body melanoma can present as chronic uveitis and refractory glaucoma.

Fluorescein Angiography in Ciliary Body Melanomas

We retrospectively studied the value of iris fluorescein angiography in predicitng benignity or malignancy in 10 cases of ciliary body melanoma with iris extension. No correlation between fluorescein-angiographic appearance and histopathologic features was observed. Fluorescein angiography adds little to the management of ciliary body melanomas with iris extension.

Iridocyclectomy for Melanomas of the Ciliary Body: A Follow-Up Study of Pathology and Surgical Morbidity

With respect to the effect of surgical treatment upon the eye and the subsequent tumor behavior, 107 cases of ciliary body melanoma treated by iridocyclectomy were studied. Surgically induced complications are discussed; 6% of the patients operated on culminated in enucleation, and 42% of the patients had a final postoperative visual acuity of 20/40 or better. Pathologically, most of the cases were spindle cell A or B; a few were mixed or epithelioid type. Histologic evidence of incomplete excision did not regularly predict recurrence in the interval of observation. Cell type is the primary prognostic feature. Local complications such as recurrence of tumor, or the rare metastasis occur early.