Carcinoma Of Choroid Research Articles

Case Report: Choroidal osteoma: Bone in the eye

We share a case of a 16-year-old girl who presented with blurring of vision in her left eye since 1 year, with fundus examination suggestive of choroidal osteoma. The detailed clinical, complimentary examinations, and multimodal imaging – fundus photo, optical coherence tomography, fundus fluorescein angiography, and B-scan ultrasonography – of the case are discussed. Choroidal osteoma is a rare benign ossifying tumor of unknown etiology characterized by mature bone replacing choroid, more commonly unilateral and predominantly affecting young females, typically manifesting in the teenage years or in the early 20s. Although choroidal osteoma is a rare benign tumor, accurate diagnosis is important because it is similar to amelanotic choroidal melanoma and metastatic choroidal carcinoma which require treatment and it is important to keep patients under observation for early detection of treatable choroidal neovascularization and other complications.

Neurogenic, Fibrous and Histiocytic Tumors of the Choroid

This review details the characteristic clinical features, diagnostic approaches, treatment and prognosis of rare tumors of choroidal tissue. The aim is to help differentiate these rare tumors from sometimes clinically similar conditions such as amelanotic choroidal melanoma and nevus, metastatic choroidal carcinoma, metastatic and dystrophic intraocular calcification. Schwannomas are benign encapsulated tumors and may present as an isolated lesion or may be associated with neurofibromatosis. They appear as yellow-white lesions on fundus examination and may be confused with amelanotic melanoma. Schwannomas can be observed without any intervention because they are benign and grow slowly. Treatment options include transscleral resection and photodynamic therapy (PDT).

Antihypertensive Drugs and Cancer: Simultaneously Development of Choroidal Melanoma and Colon Carcinoma after Administration with Valsartan/ Hydrochlorothiazide

Recently published experimental data on the presence of different types of angiotensin receptors in melanoma tissue and in breast cancer, for example, are undoubtedly alarming and indicative because Sartan therapy (in certain groups of patients) may be a risk factor for the patients themselves. The reason for this is the ability of the specific group of drugs to promote carcinogenesis by blocking certain types of receptors, presented in certain types of tumors. The available in vivo and in vitro data in the world literature on the influence of antihypertensive drugs (Sartans and Thiazide diuretics) on melanogenesis and development of other cancerous forms, although disputed, are numerous. Even more disturbing are the further data in the medical literature on the development of multiple tumors after administration of Sartans alone or in combination with hydrochlorothiazide. According to other literature data, even monotherapy with the already mentioned diuretic- hydrochlorothiazide, could be seen as a possible key or risk factor for the development of cutaneous melanoma. We present a clinical case of a 67-year-old patient with anamnestic data for systemic antihypertensive therapy with a combined preparation containing Valsartan / hydrochlorothiazide 160 mg / 12.5 mg for the period from the end of 2011 to March, 2020, came on occasion of a prophylactic dermatological examination. The examination found a pigmented lesion in the right torso, clinically and dermatoscopically suspected of thin cutaneous melanoma. According to the anamnesis and available documentation, it is clear that within this combined antihypertensive medication, the patient has developed two additional neoplasms in the recent past: choroidal melanoma and colorectal carcinoma successfully treated surgically. To what extent, the shared data (on the occurrence of multiple tumors after combination treatment with antihypertensives such as sartans and thiazide diuretics) would lead to the necessary and desirable rethinking of therapeutic strategies for the treatment of hypertension and clarification of the mechanisms at molecular level, at this moment - remains unclear. But in practice it should be highly recommended. Keywords: Melanoma; Melanogenesis; Antihypertensive Therapy; Valsartan; Sartans; Surgery; Hydrochlorothiazide

Case of successful treatment of neuroaspergillosis in oncological patient

Invasive mycoses caused by fungi of the genus Aspergillus, today remain an urgent clinical problem in oncological patients. In 10–20 % of patients with primary by aspergilloma can be detected in the Central nervous system. The article describes a case of neuroaspergillosis in an immunocompromised patient with choroid carcinoma of the right parietal-occipital lobe of the brain. Correct interpretation of risk factors, clinical symptoms and imaging techniques, early diagnosis with verification the pathological process, the use of fungistatic and fungicidal drugs allowed to avoid the negative consequences of fungal neuroinfection.

Solitary choroidal metastasis from gastric adenocarcinoma: a case report

BackgroundMetastatic choroidal carcinomas that originated from the gastrointestinal tract are extremely rare. We report a case of suspected solitary choroidal metastasis from gastric adenocarcinoma.Case presentationThe patient was a 60-year-old man who had undergone laparoscopic distal gastrectomy with D1+ lymphadenecetomy for gastric cancer. The clinical stage was T1bN0M0 (TNM classification), but the pathological stage was T4aN0M0 beyond expectation. Adjuvant chemotherapy with oral Tegafur, Gimeracil, Oteracil potassium (TS-1®) was initiated. But he suddenly complained of decreased visual acuity in his right eye about 8 months later. This was suspected to be caused by choroidal metastasis of gastric adenocarcinoma. Chemotherapy with paclitaxel (PTX) and intensity-modulated radiotherapy (IMRT) achieved complete remission and spared the patient from going blind.ConclusionsThis case demonstrates that we should be aware of the possibility of choroidal metastases, when visual symptoms arise during treatment of gastric cancer.

An oncogenetics consultation dedicated to children suffering from cancer.

e20006 Background: When a child suffers from a cancer, parents worry about a probable hereditary cause. If a cancer occurs in the context of a genetic mutation, this can worsen the situation and make it more complicated. On the other hand, when the hereditary cause is rejected, the reinsurance for the family is clear. Methods: A partnership has been set between the Oncogenetics department in Centre Antoine Lacassagne Hospital in Nice and the Archet hospital in Nice (CHU) who takes in charge the children suffering from a cancer. Fifty little patients are seen every year in the paediatric oncology service at the Archet hospital (CHU). A consultation in oncogenetics is suggested to each family and insistently when a known syndrome is suspected. This consultation is also about to provide an other kind of care, in an other hospital, focused on the family with the aim to free of guilt the parents. Psychological care for families is in backdrop as they can express freely their questioning. Results: Twenty one families have been seen and fifteen different types of cancers recorded: mostly haematological cancers and neurological cancers. For each family, a pedigree was drawn. Data concerning the child’s disease and familial data were gathered. Most of the time, these information led to reassure the families. Therefore two Li and Fraumeni syndrome have been evoked. The first child suffered from a plexus choroid carcinoma and the second one had two distinct cancers: a nephroblastoma and a medulloblastoma. On the other hand, 2 children had had a LAL within a family with history of malignant haemopaties. Interestingly, 3 children with isolated LAL in the family where suggested to contribute to a research trial. Conclusions: This oncogenetic pediatric consultation allows to detect known hereditary predisposition syndromes and to contribute to researches in paediatric oncology. Above all, this strong bound between the oncogentics department and the pediatric oncology service permitted to reach an objective: offering families a specialised consultation with psychological support with a gap from disease.

Fundus fluorescein angiography in metastatic choroidal carcinomas and differentiating metastatic choroidal carcinomas from primary choroidal melanomas

To investigate the characteristics of fundus fluorescein angiography (FFA) in metastatic choroidal carcinomas and determine the value of FFA in differentiating metastatic choroidal carcinomas from primary choroidal melanomas. It was a retrospective case series. The retrospective analysis of clinical data and FFA findings was performed in 23 eyes of 22 patients with metastatic choroidal carcinomas and 31 eyes of 31 patients with primary choroidal melanomas as the control. Ocular fundus findings of metastatic choroidal carcinomas were divided into three types: solitary flat (tumor thickness less than 3 mm), solitary elevated (tumor thickness more than 3 mm) or diffuse type. FFA of the three types showed hypofluorescence during the arterial phase and progressive hyperfluorescence during the subsequent phases. The border of the lesions revealed retinal capillary dilation during the arteriovenous phase and persistent pinpoint leakage throughout the angiogram. Retinal capillary dilation and pinpoint leakage were more frequently presented in the solitary flat type. Simultaneous visualization of retinal and tumor circulation (the so called double circulation) was more frequently presented in the solitary elevated type. Pinpoint leakage could be detected in 17 (73.91%) eyes of metastatic choroidal carcinomas and in 5 (16.13%) eyes of primary choroidal melanomas. The difference between the visibility of pinpoint leakage in metastatic choroidal carcinomas and primary choroidal melanomas was statistically significant (P = 0.0000). When pinpoint leakage of FFA was used to differentiate metastatic choroidal carcinomas from primary choroidal melanomas, the sensitivity, specificity, accuracy, positive and negative predictive values were 73.91%, 83.87%, 79.63%, 77.27%, 81.25% respectively. FFA is helpful for the diagnosis of metastatic choroidal carcinomas. Pinpoint leakage on the border of lesions has some value in differentiating metastatic choroidal carcinomas from primary choroidal melanomas.

Autofluorescence of metastatic choroidal tumor

Metastatic choroidal carcinomas are the most common intraocular neoplasms [1]; diagnosis is made by ophthalmoscopic, fluorescein angiographic (FA), and indocyanine green angiographic (IA) findings together with a history of cancer especially of the breasts and lungs. However, the general health of these patients is often poor, and it is difficult to perform these invasive examinations. Fundus autofluorescence (AF) is a noninvasive imaging technique that can detect lipofuscin in the retinal pigmented epithelial (RPE) cells [2]. A continuous AF pattern is an indication of normal metabolic activity of the RPE cells, and the loss of AF indicates that the photoreceptors or RPE cells are dysfunctional. Because FA and IA are generally not recommended in such ill patients, we questioned whether the AF pattern can be used to diagnose and follow the course of carcinomas after treatment. A Medline search did not extract any articles describing the AF findings in eyes with choroidal carcinomas. A retrospective review of patients with a choroidal carcinoma in our hospital extracted two patients who had undergone FA, IA, and AF. Thus, the purpose of this study was to determine the AF characteristics in these two eyes with a choroidal carcinoma.

Radioactive plaque therapy for metastatic choroidal carcinoma

Purpose To describe the outcome of radioactive episcleral plaque therapy for treatment of metastatic carcinoma to the choroid. Design Retrospective, noncomparative case series. Participants Five patients (six eyes) with carcinoma metastatic to the choroid. Methods Retrospective review of the clinical records of five patients (six eyes) who underwent radioactive episcleral plaque therapy for choroidal metastases. Main outcome measures Tumor height, visual acuity, radiation optic neuropathy, and radiation retinopathy. Results Radioactive episcleral plaque therapy resulted in shrinkage of the treated tumors and resolution of subretinal fluid in all eyes. After plaque treatment, best-corrected visual acuity was maintained within two lines of initial visual acuity for two eyes, decreased more than two lines for one eye, and improved more than two lines in three eyes. The treatment was well tolerated and there was no acute toxicity. Late complications included optic nerve atrophy (at 2 years) with proliferative radiation retinopathy (at 3 years) in one eye and optic atrophy (at 6 months) in another eye that had received prior external beam therapy. Conclusions In carefully selected cases, radioactive episcleral plaque therapy appears to be an effective and reasonable treatment for carcinoma metastatic to the choroid.

Chemotherapy and immunotherapy in adult malignant gliomas

This review summarizes papers published during 1991 and 1992. The poor results obtained in the postneurosurgical treatment of gliomas led researchers to pursue attempts to try to overcome glioma cell resistance. The intra-arterial route was explored in several phase II studies with new drugs and even immunoconjugates; rates of response between 30% to 60% were obtained. New drugs (fotemustine, eflornithine, and estramustine) or combined protocols planned to circumvent chemoresistance were tested and showed some efficiency with moderate toxicity, enlarging the number of drugs available against malignant gliomas. On the contrary, two retrospective analyses warned about the risk of reduction of median time to survival due to adjuvant chemotherapy in anaplastic astrocytomas; this finding, if confirmed, would suggest to defer chemotherapy at the time of recurrence in this type of glial tumor. Immunobiologic therapies as immunomodifiers, immunoconjugates, or cytotoxic lymphocyte-activated killer cells and tumor-infiltrating lymphocytes were tested and allowed some responses to be obtained. In young children, chemotherapy regimens were found to be efficient in malignant plexus choroid carcinomas and low-grade gliomas, allowing radiation therapy to be deferred. Many studies were methodologically unsatisfactory because of uncertain pathology grouping, noncompliance to initial protocols, or too small populations of patients.

Choroidal Granuloma in Sarcoidosis

We examined two patients--a 33-year-old black man and a 62-year-old white woman--who had pale yellow choroidal tumefactions with subretinal fluid and reduced vision. One patient had a history of granulomatous iritis; both patients were initially thought to have metastatic choroidal carcinoma. Systemic investigation yielded positive tissue diagnosis for sarcoidosis, leading to the diagnosis of presumed sarcoid choroidal infiltration. There was striking absence of inflammation of the retina, retinal vessels, and vitreous cavities. Fluorescein angiography disclosed initial hypofluorescence and late hyperfluorescence and ultrasonography demonstrated medium internal reflectivity. Neither study could exclude metastatic choroidal carcinoma. One patient had an increased level of angiotensin-converting enzyme on serial determinations through 15 months of observation and during treatment with corticosteroids, indicating a good correlation with improved vision and flattening of the choroidal granuloma. In both cases there was only partial resolution of the choroidal granuloma with corticosteroids. We conclude that choroidal granuloma can be the sole ocular manifestation of sarcoidosis and in this context is likely to be confused with metastatic choroidal carcinoma. We also believe that biopsy confirmation is needed because noninvasive tests such as gallium scans and angiotensin-converting enzyme cannot be relied on for diagnosing sarcoidosis and excluding carcinoma.

Fluorescein angiography of metastatic choroidal tumors.

Fluorescein angiography in metastatic choroid carcinoma revealed three patterns of fluorescence: usually early and continued progressive fluorescence; sometimes only late but progressive and diffuse fluorescence; and occasionally only early fluorescence that diminished later. No fluorescein angiographic pattern is diagnostic of metastatic choroidal carcinomas since the timing and progression of fluorescence with metastatic choroidal tumors is indistinguishable from that sometimes seen with choroidal melanomas and hemangiomas. However, some features that have been described with fluorescein angiography of hemangiomas and malignant melanomas were not seen with the metastatic tumors, and these features may be of some limited diagnostic value.

Local Irradiation of Metastatic Carcinoma of Choroid with Radioactive Iodine : A Preliminary Report

Local Irradiation of Metastatic Carcinoma of Choroid with Radioactive Iodine : A Preliminary Report

Choroidal carcinoma metastatic from the male breast.

Choroidal carcinoma metastatic from the male breast.

Metastatic Carcinoma of Choroid with Primary Focus in the Prostate Gland

Metastatic Carcinoma of Choroid with Primary Focus in the Prostate Gland

Metastatic Carcinoma of the Choroid by Report of Two Cases, Four Eyes

More cases of this condition are seen than the reports in the literature would indicate. The salient features deduced from these reports are mentioned. Two cases are reported. Carcinoma of the breast had been excised in each; in one nine years and in the other two and one-half years before. In one case one eye was excised and the pathologic examination was reported. Read before the Ophthalmic Section, Medical and Chirurgical Society of Maryland, 1925.

Carcinoma of Choroid Metastatic from Prostate

Carcinoma of Choroid Metastatic from Prostate