National Cancer Institute®
Last Modified: August 1, 2002
UI - 12062232
AU - Kiratli H
TI - Persistent intraschisis hemorrhage simulating choroidal melanoma.
SO - Jpn J Ophthalmol 2002 Mar-Apr;46(2):222-5
AD - Ocular Oncology Service, Department of Ophthalmology, Hacettepe University of Medicine, Ankara, Turkey.
BACKGROUND: Intraschisis hemorrhage of dark green color without accompanying vitreous hemorrhage is a rare complication of degenerative retinoschisis-detachment. CASE: A 37-year-old male patient with unilateral intraschisis hemorrhage closely mimicking a choroidal melanoma is described. OBSERVATIONS: Ultrasonography and intravenous fluorescein angiography suggested intraschisis hemorrhage. T(1)-weighted magnetic resonance imaging demonstrated a hyperintense lesion compared to the vitreous that did not enhance with contrast agent. Managed by observation, the color of the lesion started to change at the 6th month of follow-up. The hemorrhagic lesion regressed to half size in 40 months following the diagnosis, and disappeared in 62 months. CONCLUSION: Very rarely may an intraschisis hemorrhage secondary to degenerative retinoschisis-detachment simulate a choroidal melanoma. In our patient, careful interpretation of the conventional methods was adequate for the differential diagnosis. The unusual feature of this patient was that the hemorrhage resolved in 5 years, much slower than expected.
UI - 12147581
AU - Chen X; Maniotis AJ; Majumdar D; Pe'er J; Folberg R
TI - Uveal melanoma cell staining for CD34 and assessment of tumor vascularity.
SO - Invest Ophthalmol Vis Sci 2002 Aug;43(8):2533-9
AD - Department of Pathology, University of Illinois at Chicago, Chicago, Illinois, USA.
PURPOSE: Aggressive melanoma cells may express endothelial markers that can be used to calculate microvascular density (MVD). High MVD has been associated with adverse outcome in uveal melanoma. If tumor cells label with endothelial cell markers, then MVD may not accurately reflect a tumor's vascularity. This study was designed to study the influence of melanoma cell labeling by endothelial cell markers on MVD. METHODS: Tissue sections of 200 ciliary body or choroidal melanomas were stained with CD34 alone, and the MVD was calculated by counting discrete foci of CD34 labeling in hot spots, as described previously. From adjacent sections double labeled by fluorescent immunohistochemical stains for S100 protein and CD34, tumor cells labeling with both markers were identified. The relationship between marker coexpression and MVD was tested. Tissue sections were also double labeled for Melan-A and CD34. RESULTS: MVD was found to be associated with death from metastatic melanoma as reported previously. However, colocalization of both Melan-A and S100 protein with CD34 was demonstrated. The labeling of tumor cells by CD34 was associated with an elevated calculation of MVD (P < 0.0001) but not with cell type, mitotic figures, tumor-infiltrating lymphocytes, or PAS-positive patterns. CONCLUSIONS: CD34 may label uveal melanoma cells and may contribute to computation of MVD. Although MVD is prognostically significant in uveal melanoma, this feature is not an exclusive measure of tumor vascularity.
UI - 12147585
AU - van den Aardweg GJ; Naus NC; Verhoeven AC; de Klein A; Luyten GP
TI - Cellular radiosensitivity of primary and metastatic human uveal melanoma cell lines.
SO - Invest Ophthalmol Vis Sci 2002 Aug;43(8):2561-5
AD - Department of Radiation Oncology, Division of Clinical Radiobiology, University Hospital Rotterdam, Rotterdam, The Netherlands. firstname.lastname@example.org
PURPOSE: To investigate the radiosensitivity of uveal melanoma cell lines by a clonogenic survival assay, to improve the efficiency of the radiation regimen. METHODS: Four primary and four metastatic human uveal melanoma cell lines were cultured in the presence of conditioned medium. After single-dose irradiation (0-12 Gy), colonies were allowed to form for 6 to 14 days. Two cutaneous melanomas cell lines were also tested for comparison. The survival curves were analyzed by the linear quadratic (LQ) model, and the surviving fraction at a dose of 2 Gy (SF(2)), the SF at 10 Gy (SF(10)), the ratio of initial irreparably damaged DNA (alpha-coefficient) to the capacity to repair sublethally damaged DNA (beta-coefficient), and the plating efficiency were calculated. RESULTS: The melanomas displayed a wide range of initial irreparable DNA damage (alpha-component), as well as a capacity for repair of sublethal DNA damage (beta-component), which ultimately resulted in a wide range of alpha/beta ratios. These findings were similar in both primary and metastatic melanomas and were comparable with data obtained from two cutaneous melanomas. CONCLUSIONS: Cell lines obtained from primary and metastatic human uveal melanomas displayed a wide range of radiosensitivity, similar to that published for cutaneous melanomas. Translating these data to the clinical setting indicates that a fractionated dose of 8 to 10 Gy administered in three to four fractions, as currently delivered in many centers, should be sufficient to eradicate tumors of approximately 1 cm(3).
UI - 12147588
AU - Bergman L; Seregard S; Nilsson B; Ringborg U; Lundell G;
TI - Ragnarsson-Olding B Incidence of uveal melanoma in Sweden from 1960 to 1998.
SO - Invest Ophthalmol Vis Sci 2002 Aug;43(8):2579-83
AD - St. Eriks Eye Hospital and. Radiumhemmet, Karolinska Hospital, Stockholm, Sweden. email@example.com
PURPOSE: To investigate the incidence of uveal melanoma in Sweden during the period from 1960 to 1998, with respect to age distribution, gender, and changes in incidence over time. METHODS: The Swedish Cancer Registry was searched for patients with uveal melanoma and cross-checked against hospital files over patients where an eye-sparing treatment had been applied, to ensure inclusion in the Registry even when no histologic specimen was available. The crude and age-standardized incidence was estimated separately for each gender. The Swedish population of 1970 to 1974 was used as a standard, and the annual change in incidence was calculated by using a regression model with logarithmic incidence numbers. RESULTS: In total, 2997 patients met the criteria, of whom 1542 were males and 1455 females. During the 39-year period, the age-standardized incidence of uveal melanoma declined significantly in the male population, from 11.7 cases/million to 8.4 cases/million (P = 0.002). The trend toward reduced incidence in females, from 10.3 to 8.7 cases/million did not reach statistical significance (P = 0.108). The annual relative change in incidence was 1% (95% CI, 0.8%-1.2%) in males and 0.7% (95% CI, 0%-1.3%) in females. The age-specific incidence revealed a significantly higher incidence among men older than 45 years (23.5 cases/million) compared with the incidence in women of the same age group (19.2 cases/million; P < 0.001). CONCLUSIONS: A Swedish national survey performed to establish the incidence of uveal melanoma during the period from 1960 to 1998 revealed a decreasing incidence in the male and a stable incidence in the female population.
UI - 12059874
AU - Alyahya GA; Heegaard S; Prause JU
TI - Characterization of melanoma associated spongiform scleropathy.
SO - Acta Ophthalmol Scand 2002 Jun;80(3):322-6
AD - Eye Pathology Institute, University of Copenhagen, Denmark.
PURPOSE: Melanoma associated spongiform scleropathy (MASS) describes areas within the sclera where collagen bundles appear to have disintegrated into loose fibres. It is found adjacent to choroidal and ciliary body melanoma. This study aimed to characterize these changes histopathologically. METHODS: Sections of 218 eyes that had been were examined for MASS, using data collected from the files of the Eye Pathology Institute, University of Copenhagen. Findings were correlated to patient characteristics (age, gender and pre-enucleation radiation) and tumour characteristics (location, morphology and invasion). Staining was applied using haematoxylin-eosin (HE), periodic acid-Schiff (PAS), haematoxylin-phloxine-saffron (HPS), alcian blue, colloidal iron and Masson's trichrome. Sixteen normal eyes and 29 eyes with diseases other than choroidal and ciliary body melanoma served as controls. RESULTS: Melanoma associated spongiform scleropathy was observed in 73 of the 218 eyes (33%) with melanoma. No changes were found in normal eyes or in eyes with other intraocular diseases. A significantly higher incidence of MASS was found in older age groups. Thirty-six (49%) of the 73 cases of MASS were observed within a patient age range of 71-90 years, whereas only 14 cases (19%) were observed within an age range of 41-60 years. Pre-enucleation radiation significantly reduced the incidence of MASS. Twenty-two (10%) of the total 218 eyes had received pre-enucleation radiation and in only two (1%) of these was MASS observed. Melanoma associated spongiform scleropathy was found only in areas of contact between the tumour and the sclera, and the degree of MASS correlated directly with the extent of this contact. No significant correlation with tumour cell type was found. CONCLUSIONS: In eyes with MASS, the severity of the changes correlated to the extent of direct contact between the tumour and sclera. Melanoma associated spongiform scleropathy showed a significant predilection towards older age groups. Pre-enucleation radiation significantly reduced the incidence of MASS. Melanoma associated spongiform scleropathy is probably caused by a deposition of amorphous material splitting the scleral collagen fibrils. This material may be secreted either directly from the adjacent tumour or from scleral fibroblasts stimulated by the tumour cells.
UI - 12055477
AU - Saricaoglu MS; Guven D; Karakurt A; Sengun A; Ziraman I
TI - An unusual case of Sturge-Weber syndrome in association with phakomatosis pigmentovascularis and Klippel-Trenaunay-Weber syndrome.
SO - Retina 2002 Jun;22(3):368-71
AD - Third Eye Clinic and Third Radiology Clinic, Ankara Numune Teaching and Research Hospital, Ankara, Turkey.
UI - 12055478
AU - Keunen JE; Hooymans JM; Ulbig MW; Shields CL
TI - Retinal neovascularization in choroidal melanoma without retinal ischemia.
SO - Retina 2002 Jun;22(3):371-4
AD - Ocular Oncology Service, Leiden University Medical Center, Leiden, the Netherlands. firstname.lastname@example.org
UI - 12153810
AU - Demirci H; Shields CL; Shields JA; Eagle RC Jr; Honavar SG
TI - Diffuse iris melanoma: a report of 25 cases.
SO - Ophthalmology 2002 Aug;109(8):1553-60
AD - Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
BACKGROUND: Diffuse iris melanoma is a rare variant of iris melanoma that has a flat growth pattern and often presents as unilateral hyperchromic heterochromia and glaucoma. There have been no large clinical reports of diffuse iris melanoma. DESIGN: Single-center retrospective case series. PARTICIPANTS: Twenty-five consecutive patients with diffuse iris melanoma. METHODS: A review of the clinical features, management, histopathologic analysis, and prognosis was performed. MAIN OUTCOME MEASURES: Clinical features, histopathologic features, management, and prognosis. RESULTS: At the time of diagnosis, the mean patient age was 49 years. The initial complaint was unilateral darker eye color in 13 cases (52%) and blurred vision in 6 (24%). Six patients (24%) were symptom free. On presentation elsewhere, the initial diagnosis was iris melanoma or nevus in 11 cases (44%) and glaucoma in 14 (56%), 8 (32%) of whom had prior laser or surgical treatment for glaucoma. The 25 patients were observed for a mean of 30 months before the diagnosis of melanoma was suspected and referral to our center for evaluation. The mean intraocular pressure at referral was 36 mmHg, and the mean number of clock hours involved by tumor was 11. Heterochromia iridis was present in all 25 cases (100%), corectopia in 23 (92%), and ectropion iridis in 21 (84%). Associated findings included unilateral cataract in 8 (32%), a prominent episcleral (sentinel) vessel in 7 (28%), and anterior chamber inflammation in 5 (20%), and synechiae (anterior or posterior) in none. The tumor was managed by enucleation in 22 cases (88%) and by plaque brachytherapy in 3 (12%). Five cases (20%) were classified as spindle melanoma, 17 (68%) as mixed cell type, and 3 (12%) as epithelioid cell type. Therefore, histopathologic examination showed that 80% of cases contained epithelioid cells. All 22 enucleated cases were found to have tumor invasion in the trabecular meshwork. Tumor invasion of Schlemm's canal was found in 18 (82%), minor pars plicata in 12 (55%), and episclera in 7 cases (28%). Of seven cases with episcleral invasion, four underwent surgical treatment for glaucoma. Excluding one recent case, the patients were observed for a mean of 78 months. Liver metastasis developed in 3 cases (13%). CONCLUSIONS: Diffuse iris melanoma is a serious ocular condition that causes unilateral hyperchromic heterochromia and secondary glaucoma, often leading to a delay in diagnosis. Local invasion of adjacent ocular structures is common, and distant metastasis occurs in 13% of cases at mean follow-up of 78 months.
UI - 12029570
AU - Pigeaud-Klessens ML; van der Valk P
TI - Multiple neoplasms: a case report.
SO - Orbit 2002 Jun;21(2):145-8
AD - Department of Ophthalmology, VU-Medical Center, Amsterdam, The Netherlands.
Patients diagnosed with Chronic Lymphocytic Leukemia (CLL) have an increased risk of developing second primary cancers. However, as far as we know, more than one type of subsequent malignancy in one patient has not been described. We report a case of two different skin cancers following CLL. A 68-year-old female patient, in whom CLL was diagnosed 5 years earlier, presented with a pigmentation in the left lower eyelid. Biopsy showed a melanoma. The tumor was excised and histopathological examination revealed a superficial spreading melanoma. Half a year later, a new pigmented tumor was seen in the transplant of the left lower eyelid. Biopsy was performed and histopathological examination showed an intraepithelial squamous cell carcinoma. This was treated with 5 fluorouracil 1% eyedrops.
UI - 12149065
AU - Lumbroso L; Sigal-Zafrani B; Jouffroy T; Levy C; Rodriguez J; Desjardins
TI - L Late malignant melanoma after treatment of rhabdomyosarcoma of the orbit during childhood.
SO - Arch Ophthalmol 2002 Aug;120(8):1087-90
AD - Institut Curie, 26 Rue d'Ulm, 75005 Paris, France. email@example.com
UI - 11930109
AU - Mulcahy KA; Alexander S; Platts KE; Wardle C; Sisley K; Rennie IG;
TI - Murray AK CD80-mediated induction of immunostimulation in two ocular melanoma cell lines is augmented by interferon-gamma.
SO - Melanoma Res 2002 Apr;12(2):129-38
AD - Section of Oncology and Pathology (Cancer Studies), University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK.
Although the transfection of the T-cell costimulatory molecule CD80 cDNA into human tumours can augment their immunogenicity in vitro, its expression alone is ineffective in many tumour systems. We evaluated the influence of CD80 expression on the immunostimulatory activity of ocular melanoma cell lines and determined whether IFN-gamma could enhance the effect. Two ocular melanoma cell lines were transfected with CD80 cDNA. The immunostimulatory capacity of the CD80+ transfectants was determined by their ability to stimulate the proliferation of allogeneic peripheral blood mononuclear cells (PBMC). The influence of additional accessory molecules on PBMC proliferation was assessed by pre-treating the CD80 transfectants with IFN-gamma. The CD80+ transfectants induced proliferation of allogeneic PBMC. IFN-gamma treatment of the tumour cells induced upregulated expression of MHC class I, de novo expression of MHC class II and CD54, and enhanced the ability of the CD80+ transfectants to stimulate PBMC proliferation. CD4+ T cells were not required for the proliferative response against untreated CD80+ tumour cells but were necessary for the augmentation of proliferation observed following IFN-gamma treatment. CD80+ ocular melanoma cells possess immunostimulatory potential which is augmented by IFN-gamma induced upregulation of cell surface molecules. Further studies on the role of costimulatory molecules in inducing anti-tumour immunity in ocular melanoma may help to define new strategies for application of immunotherapeutic approaches to treat this aggressive disease.
UI - 11930116
AU - Belt PJ; Smithers M; Elston T
TI - The triad of bilateral retinoblastoma, dysplastic naevus syndrome and multiple cutaneous malignant melanomas: a case report and review of the literature.
SO - Melanoma Res 2002 Apr;12(2):179-82
AD - Department of Plastic and Reconstructive Surgery, University of Queensland, Princess Alexandra Hospital, Brisbane, Queensland, Australia. firstname.lastname@example.org
We report a case of a patient with the triad of retinoblastoma, dysplastic naevus syndrome (DNS) and multiple cutaneous melanomas. The combination of retinoblastoma and DNS is a significant risk factor for the development of cutaneous melanoma. This risk extends to family members. We recommend that survivors of (inherited) retinoblastoma and their relatives are closely screened for the presence of dysplastic naevi.
UI - 11898358
AU - Likhvantseva VG
TI - [Prospects for developing treatment of uveal melanoma from the position of modern carcinogenesis concepts]
SO - Vestn Oftalmol 2002 Jan-Feb;118(1):32-5
Immunohistochemical studies of regulator proteins p53, Bcl-2, Bax, Ki-67, and CD-95L showed that apoptosis suppression, allowing unlimited proliferation of tumor cells, plays an important role in the carcinogenesis of uveal melanoma. This fact dictates the need of including drugs arresting suppression or inducing apoptosis in therapeutic protocols for uveal melanoma. Prognostic significance of p53, Bcl-2, Bax, and CD-95L was demonstrated. Each of the peptides can be used as a prognostic marker.
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