Presentation
When uveal melanoma presents in an atypical way, the diagnosis is more difficult. This case highlights the uncommon presentations of malignant melanoma of the choroid. [ncbi.nlm.nih.gov]
Entire Body System
- Pain
Histopathological examination of evisceration specimens disclosed previously unsuspected uveal melanoma in 7 patients who were treated for blind, painful eyes. [ncbi.nlm.nih.gov]
[…] blood vessels growing in the angle (i.e., 'neovascular glaucoma'). inflammation, if part of the tumour dies (i.e., becomes 'necrotic'). pushing of the eye outwards if tumour grows large behind the eye (i.e., causing 'proptosis'). eventually, a blind, painful [itumor.org]
[…] eye, arising from the choroid in 90% of cases and from the iris and ciliary body in the other 10% of cases, which clinically presents with visual symptoms (including blurred vision, photopsia, floaters, and visual field reduction), a visible mass and pain [orpha.net]
- Fishing
Sensitivity and specificity were 95.2% and 80.8%, respectively, for SNP, 77.8% and 64.7%, respectively, for FISH, and 85.0% and 72.0%, respectively, for aCGH. Isodisomy 3 was identified by SNP but undetected by aCGH and FISH in three tumors. [ncbi.nlm.nih.gov]
Dual-color FISH was done as described previously ( 19 ). [doi.org]
- Pathologist
Given the known difficulty in recognizing a small dermal blue nevus-like melanoma metastasis by light microscopic findings alone, recent discoveries of unique cytogenetic aberrations in various types of melanomas have led pathologists to explore cytogenetic [ncbi.nlm.nih.gov]
(PMID: 27718540) A research team led by principal investigator Mohamed Abdel-Rahman, MD, PhD, an ophthalmologic pathologist and cancer geneticist at the OSUCCC – James, has received National Institutes of Health (NIH) funding for a study of “Hereditary [cancer.osu.edu]
A tissue sample is taken during a biopsy and sent to a pathologist (a doctor who specializes in diagnosing disease). The pathologist examines the cells under a microscope and will determine the type of melanoma and the stage. [mskcc.org]
We offer c oordinated care with other specialists at OHSU including medical and radiation oncologists, neurointerventional radiologists, dermatologists, pathologists and anesthesiologists. [ohsu.edu]
There is no consensus amongst pathologists as to what proportion of cells need to be epithelioid for the tumour to be categorized as 'mixed' or 'epithelioid'. [looc.uk.com]
- Severe Pain
Key features are elevated eye pressure, forward movement of diaphragm combined with severe pain ( Yang et al, 2003 ). Posterior nodular scleritis is rare, but often underdiagnosed. [intechopen.com]
Gastrointestinal
- Abdominal Pain
Among the symptomatic group, metastasis was diagnosed in 259 patients (74.2%) after the onset of symptoms, such as anorexia or abdominal pain. [jamanetwork.com]
- Loss of Appetite
Around 8 months later, he had developed some vague symptoms like loss of appetite and weakness. [cancerjournal.net]
Eyes
- Eye Pain
Infection is often a result of keratitis, although dry eyes and underlying medical disease can also inflame the cornea. Eye pain and redness, excess tears, difficulty opening the eye, blurred vision, and light sensitivity can be signs of keratitis. [houstonmethodist.org]
Signs of glaucoma include eye pain, redness and blurry vision. Ocular melanoma may also lead to vision changes and vision loss. Very advanced cases can cause complete vision loss. [cbsnews.com]
Signs and symptoms of glaucoma may include eye pain and redness, as well as blurry vision. Vision loss. [mayoclinic.org]
Enucleation removes the whole eye, in cases where the tumor is large, and any other treatment would result in the loss of most of the eye. It may also be recommended if there is eye pain. [medicalnewstoday.com]
In a single-center, phase I–II study of 57 evaluable patients treated with carbon ion-beam irradiation and followed for a median of 26 months, 26 patients developed neovascular glaucoma or severe eye pain from increased intraocular pressure, and 3 patients [cancer.gov]
Neurologic
- Asthenia
An ORR was not seen with docetaxel alone versus 37% with the combination ( P The most frequently reported grade 3/4 AEs with selumetinib versus without were neutropenia (67% vs 55%), febrile neutropenia (18% vs none), dyspnea (2% vs 12%), and asthenia [onclive.com]
- Seizure
Patel said that valproic acid, which is commonly used to treat seizures, also inhibits histone deacetylase and is inexpensive. [mdanderson.org]
- Perseveration
We and our families put these actions to good use, along with hope and perseverance, during her courageous battle with metastatic ocular melanoma. I would also like this website to be a place of encouragement. [eyemelanoma.org]
- Irritability
Sometimes, blurred vision is associated with other symptoms, depending upon its cause, including headache, sensitivity to light, or redness and irritation of the eyes. Being older and having fair skin may increase the risk of intraocular melanoma. [medicinenet.com]
Workup
When distant metastases are found during the initial systemic workup, treatment of the intraocular melanoma itself becomes palliative. [emedicine.com]
If one of the high-risk indicators, mentioned previously is found, there is reasonable evidence for potential growth and many authorities recommend advancing the workup and obtaining a biopsy. [eyewiki.aao.org]
Other Pathologies
- Lymphocytic Infiltrate
Immunology[edit] The normal uvea consists of immune competent cells, particularly lymphocytes, and is prone to respond to inflammation by developing lymphocytic infiltrates. [en.wikipedia.org]
A dense lymphocytic infiltrate was adjacentto the metastatic lesion (hematoxylin-eosin, original magnification ×200). Observation was elected. In October 1996, CT showed an increase in metastasisto the rest of the liver. [jamanetwork.com]
Other histological factors indicating an increased risk of metastasis include: closed loops; lymphocytic infiltrates; macrophages; and high microvascular density. [mmmp.org]
The presence of tumour infiltrating lymphocytes was assessed using immunohistochemical antibodies for B cells, L-26 (Dako) and T cells UCHL-1 (Dako). Significance was considered as more than 100 lymphocytes per 20 high-powered (43×) fields [ 7 ]. [bmcophthalmol.biomedcentral.com]
Treatment
The size of the tumor determined the treatment decision. [bmctoday.net]
While early diagnosis increases treatment options for the primary tumor, whether early treatment decreases a patient’s chance of developing metastatic disease is unknown. [mdanderson.org]
When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. [cancer.gov]
The molecule is activated by a standard ophthalmologic laser and treatment will be administered in an outpatient visit. [businesswire.com]
General treatment The primary goal of treatment for uveal melanomas is to prevent metastasis. [eyewiki.aao.org]
Prognosis
Keywords: Ciliary body, choroid, eye, iris, melanoma, metastasis, prognosis, tumor, uvea How to cite this article: Kaliki S, Shields CL, Shields JA. Uveal melanoma: Estimating prognosis. [ijo.in]
They found 2 distinct tumor classes, one with a poor prognosis and one with improved prognosis. [retinatoday.com]
Table 6: Features predictive of poor prognosis for posterior uveal melanoma Clinical features predicting prognosis Although the influence of age on the prognosis of uveal melanoma is uncertain, recent studies indicate that a poor prognosis is more likely [nature.com]
Array-based CGH revealed no CNVs on tumor cells associated with poor prognosis; namely, no monosomy 3, losses of 1p, 6q, or 8p, and no gains of 8q. [ncbi.nlm.nih.gov]
Prognosis [ 18 ] The prognosis depends mostly on the genetic alterations and tumour size. Every millimetre increase in thickness leads to a 5% increased risk for metastasis. [ 1 ] Median survival after liver metastasis is poor (4-6 months). [patient.info]
Etiology
The scope of this review is to discuss the differences in tumorigenic processes (etiologic factors and genetic alterations) and tumor biology (gene expression and signaling pathways) between CM and UM. [ncbi.nlm.nih.gov]
Although ultraviolet (UV) radiation is a proven risk factor for skin melanoma, the role of UV light in the etiology of uveal melanoma is still contradictory. [ingentaconnect.com]
Etiology Clinical features Diagnostics Pathology Cytology Spindle-shaped cells: best prognosis Type A → thin nucleus and no visible nucleoli Type B → large nucleus and visible nucleoli Epithelioid melanoma : poor prognosis Large polygonal cells and prominent [amboss.com]
Etiology Despite a large amount of epidemiological and molecular studies, the etiology of uveal melanoma remains largely obscure. [atlasgeneticsoncology.org]
Epidemiology
Article Navigation Affiliations of authors: Clinical Epidemiology Unit, Institute of Medical Epidemiology, Biometry and Informatics, Medical Faculty, Martin-Luther-University of Halle-Wittenberg, Halle, Germany (AS, AS-P); Department of Epidemiology, [doi.org]
Epidemiology Epidemiological data refers to the US, unless otherwise specified. [amboss.com]
The Authors reviewed literature concerning epidemiology and etiopathogenesis of uveal melanoma, and its clinical, histopathological and cytogenetic prognosticators. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. [ncbi.nlm.nih.gov]
Pathophysiology
An ambitious multidisciplinary approach is proposed to move from patient tissue to the preclinical evaluation of single drugs or combinations and the generation of scientific knowledge of UM pathophysiology. [universiteitleiden.nl]
The pathophysiology of uveal melanoma is currently not well understood. [eyewiki.aao.org]
Pathophysiology Melanoma in the ciliary body poses a serious threat to life. It usually remains hidden behind the iris diaphragm, growing undetected for longer periods of time than melanoma in the iris or choroid. [emedicine.medscape.com]
Alternatively, PC's overexpression is required to sustain these pathophysiological functions to maintain cancer cells immortality. [0009] The situation becomes more complex as the expression/activity of PCs is modulated differently in various cancer cells [google.com]
Prevention
The research from this project could lead to the identification of a drug therapy that could prevent the growth and spread of this condition. [pharmatimes.com]
Patients with phthisical eyes should undergo appropriate imaging techniques to prevent a missed diagnosis of optic nerve involvement. [ncbi.nlm.nih.gov]
This randomized phase II trial studies how well sunitinib malate or valproic acid works in preventing high-risk uveal (eye) melanoma from spreading to other parts of the body. [clinicaltrials.gov]