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Treated choroidal melanoma with late metastases to the contralateral orbit.

George S, Cooke CA, Mc Ginnity GF, White S, Venkatraman L - Clin Med Pathol (2009)

Bottom Line: Choroidal melanoma is the commonest adult primary intraocular tumour,1 and usual sites of secondary spread are to liver, bone and lung.Although delayed recurrence of ipsilateral orbital melanoma is well documented, metastasis to the contralateral orbit is a rarely encountered phenomenon.We describe a case of metastatic spread to the contralateral orbit in a patient 12 years after proton beam radiotherapy of choroidal melanoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology.

ABSTRACT
Choroidal melanoma is the commonest adult primary intraocular tumour,1 and usual sites of secondary spread are to liver, bone and lung. Although delayed recurrence of ipsilateral orbital melanoma is well documented, metastasis to the contralateral orbit is a rarely encountered phenomenon. We describe a case of metastatic spread to the contralateral orbit in a patient 12 years after proton beam radiotherapy of choroidal melanoma.

No MeSH data available.


Related in: MedlinePlus

A) Section of the orbital biopsy showing fragments of necrotic tumour. B) Pleomorphic tumour cells with prominent nucleoli. Some tumour cells contain melanin pigment. E) HMB45 stains the viable tumour cells while the necrotic areas are unstained. F) MELAN A stain within viable tumour cells.
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f3-cpath-2009-005: A) Section of the orbital biopsy showing fragments of necrotic tumour. B) Pleomorphic tumour cells with prominent nucleoli. Some tumour cells contain melanin pigment. E) HMB45 stains the viable tumour cells while the necrotic areas are unstained. F) MELAN A stain within viable tumour cells.

Mentions: In July 2005, the patient now aged 85, presented with sudden, non-axial, painless proptosis of the right globe associated with upper lid ptosis. There was 2 mm proptosis and medial and inferior displacement of 2 mm and 8 mm respectively (Fig. 1). There was associated oedema and erythema of the soft tissue but no significant pain or heat on palpation. Orbital CT displayed a well-defined, non-enhancing, rounded mass lesion in the superolateral right orbit extending medially and inferiorly into the intraconal space displacing the superior rectus and optic nerve (Fig. 2). Histology of the biopsied lesion showed a necrotic malignant melanoma composed of epithelioid cells containing large nuclei with prominent nucleoli and a moderate amount of pink cytoplasm. Focally the cells contained melanin pigment. These expressed the melanocytic markers melan A and HMB 45 on immunohistochemistry but were non-reactive to S100 and CAM 5.2. (Fig. 3).


Treated choroidal melanoma with late metastases to the contralateral orbit.

George S, Cooke CA, Mc Ginnity GF, White S, Venkatraman L - Clin Med Pathol (2009)

A) Section of the orbital biopsy showing fragments of necrotic tumour. B) Pleomorphic tumour cells with prominent nucleoli. Some tumour cells contain melanin pigment. E) HMB45 stains the viable tumour cells while the necrotic areas are unstained. F) MELAN A stain within viable tumour cells.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC2990236&req=5

f3-cpath-2009-005: A) Section of the orbital biopsy showing fragments of necrotic tumour. B) Pleomorphic tumour cells with prominent nucleoli. Some tumour cells contain melanin pigment. E) HMB45 stains the viable tumour cells while the necrotic areas are unstained. F) MELAN A stain within viable tumour cells.
Mentions: In July 2005, the patient now aged 85, presented with sudden, non-axial, painless proptosis of the right globe associated with upper lid ptosis. There was 2 mm proptosis and medial and inferior displacement of 2 mm and 8 mm respectively (Fig. 1). There was associated oedema and erythema of the soft tissue but no significant pain or heat on palpation. Orbital CT displayed a well-defined, non-enhancing, rounded mass lesion in the superolateral right orbit extending medially and inferiorly into the intraconal space displacing the superior rectus and optic nerve (Fig. 2). Histology of the biopsied lesion showed a necrotic malignant melanoma composed of epithelioid cells containing large nuclei with prominent nucleoli and a moderate amount of pink cytoplasm. Focally the cells contained melanin pigment. These expressed the melanocytic markers melan A and HMB 45 on immunohistochemistry but were non-reactive to S100 and CAM 5.2. (Fig. 3).

Bottom Line: Choroidal melanoma is the commonest adult primary intraocular tumour,1 and usual sites of secondary spread are to liver, bone and lung.Although delayed recurrence of ipsilateral orbital melanoma is well documented, metastasis to the contralateral orbit is a rarely encountered phenomenon.We describe a case of metastatic spread to the contralateral orbit in a patient 12 years after proton beam radiotherapy of choroidal melanoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology.

ABSTRACT
Choroidal melanoma is the commonest adult primary intraocular tumour,1 and usual sites of secondary spread are to liver, bone and lung. Although delayed recurrence of ipsilateral orbital melanoma is well documented, metastasis to the contralateral orbit is a rarely encountered phenomenon. We describe a case of metastatic spread to the contralateral orbit in a patient 12 years after proton beam radiotherapy of choroidal melanoma.

No MeSH data available.


Related in: MedlinePlus