Brain Neoplasms ; drug therapy ; Cardiovascular Diseases ; drug therapy ; Eye Diseases ; drug therapy ; Gastrointestinal Neoplasms ; drug therapy ; Head and Neck Neoplasms ; drug therapy ; Humans ; Lung Neoplasms ; drug therapy ; Neoplasms ; drug therapy ; Photochemotherapy ; Precancerous Conditions ; drug therapy ; Skin Diseases ; drug therapy ; Skin Neoplasms ; drug therapy ; Tooth Diseases ; drug therapy ; Urologic Neoplasms ; drug therapy

Lymphomas in the eye tend to be localized and to have a better prognosis. We reviewed the clinical presentation, treatment outcome and complications of primary lymphomas of the eye at a single institute focusing on the clinical significance of adequate staging and the prognostic value of pathological subtypes. Twenty-four patients with lymphoproliferative lesion of the eye were treated and followed up. The orbit was the most commonly involved site. Twenty-one patients had unilateral diseases and three patients had bilateral. Histological findings revealed 22 malignant lymphomas, one inflammatory pseudotumor and one atypical lymphoid hyperplasia. Using the NCI Working Formulation, most of the malignant lymphomas were primarily low grade: diffuse small lymphocytic, 15; diffuse small cleaved three; diffuse large cell, three; and diffuse mixed, one. The stages of lymphoma were IAE in 21 patients, IBE in one patient, and IIAE in two patients. Twenty-five of the 27 treated eyes remained disease-free during the median follow-up period of 16 months. Nineteen patients received radiotherapy, five patients received chemo-radiotherapy and one patient received only surgical excision. Two patients relapsed outside the treated field. None of the patients complained of severe dry eye syndrome or cataract formation. In conclusion, after complete staging work-up, locally-confined low grade orbital lymphomas can be up to 90% controlled with radiotherapy alone. By contrast, combined treatment is advised in patients with intermediate and high grade lesions.
Adolescence ; Adult ; Aged ; Antineoplastic Agents, Combined/therapeutic use ; Combined Modality Therapy ; Eye Neoplasms/radiotherapy* ; Eye Neoplasms/pathology* ; Eye Neoplasms/drug therapy ; Female ; Human ; Lymphoma/radiotherapy* ; Lymphoma/pathology* ; Lymphoma/drug therapy ; Male ; Middle Age ; Neoplasm Staging ; Survival Analysis

The chemosensitizing effects of cyclosporin A and verapamil on the cytotoxicity of adriamycin were investigated using MTT assay against two human retinoblastoma cell lines, Y79 and WERI-Rb-1. Y79 and WERI-Rb-1 were totally resistant to doses up to 5.0 micrograms/ml of verapamil. Cyclosporin A inhibited the survival of Y79 and WERI-Rb-1 dose-dependently, however, the maximum inhibition at the highest concentration tested (5.0 micrograms/ml) was less than 50% (% survival at 5.0 micrograms/ml of cyclosporin A: 65.6% and 66.9% in Y79 and WERI-Rb-1, respectively). Combination of cyclosporin A and verapamil did not further inhibit the survival of Y79 and WERI-Rb-1 compared with cyclosporin A alone. Adramycin inhibited the survival of Y79 and WERI-Rb-1 dose-dependently. The chemosensitizing effects of cyclosporin A and verapamil on the cytotoxicity of adriamycin were evaluated in terms of sensitizing index (SI: the ratio of IC50 to adriamycin alone to IC50 to adriamycin in the presence of cyclosporin A and/or verapamil). Cyclosporin A significantly enhanced SI and the addition of verapamil enhanced SI further: SI values at 5.0 micrograms/ml of cyclosporin A, 5.0 micrograms/ml of cyclosporin A plus 1.5 micrograms/ml of cyclosporin A plus 1.5 micrograms/ml of verapamil, 5.0 micrograms/ml of cyclosporin A plus 3.0 micrograms/ml of verapamil were 2.0, 2.6 and 2.8 in Y79 and 2.6, 5.8 and 9.7 in WERI-Rb-1, respectively. These results suggest that cyclosporin A and verapamil are promising chemosensitizers to adriamycin in the treatment of retinoblastoma.
Cell Survival/drug effects ; Cyclosporine/*pharmacology ; Doxorubicin/*pharmacology ; Eye Neoplasms/drug therapy/*pathology ; Humans ; Retinoblastoma/drug therapy/*pathology ; Tumor Cells, Cultured ; Verapamil/*pharmacology

A 40-year-old female visited our clinic for visual disturbance of the right eye, in which a few creamy-yellow retinal lesions and visual field constrictions were noted. She had been treated for primary CNS lymphoma and was in complete remission. After failure to follow-up for three months, she lost vision in the right eye, at which time active panuveitis was seen. Decreased vision and field constriction was observed in the left eye. Her left eye showed a granular pattern and dye leakage from the vessels and disc on fluorescein angiography and small RPE humps were seen in optical coherence tomography (OCT). Diffuse large malignant B-cells with strong immunoreactivities with CD20 immunostaining were seen in the epiretinal membrane biopsy specimen. Intravitreal injections of methotrexate (MTX) (800 microgram/0.1 ml in the right eye, 400 microgram/0.05 ml in the left eye) were performed twice weekly for one month, once weekly for the following month, once every two weeks for the next month, followed by nine monthly injections. Both eyes were free from malignant cells on vitreous biopsy six months later. There was no leakage seen by angiography, but the granular pattern persisted. Visual field constriction was slightly improved, and the small RPE humpsdetachments seen in OCT disappeared. EOG Arden ratio was decreased in both eyes, and b wave amplitude of scotopic ERG was decreased in the left eye. She was free from recurrence until six months later. No ocular complications except minimal opacity of the crystalline lenses were noted in both eyes.
Adult ; Antimetabolites, Antineoplastic/*administration & dosage ; Drug Administration Schedule ; Eye Neoplasms/*drug therapy ; Female ; Humans ; Injections ; Lymphoma/*drug therapy ; Methotrexate/*administration & dosage ; Treatment Outcome ; Vitreous Body

Antineoplastic Agents ; therapeutic use ; Carcinoma, Adenoid Cystic ; drug therapy ; secondary ; Erlotinib Hydrochloride ; therapeutic use ; Eye Neoplasms ; drug therapy ; secondary ; Humans ; Lacrimal Apparatus

The aim of this study was to analyze the efficacy of first-line chemotherapy in treating patients with ocular adnexal extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT). Eight consecutive newly diagnosed ocular adnexal MALT lymphoma patients were treated with chemotherapy, in which 3 patients in stage IE were treated with a combination of cyclophosphamide, vincristine and prednisolone (COP) or cyclophosphamide, adriamycin, vincristine, and prednisolone (CHOP), 5 patients in stage IV were treated with COP/CHOP in combination with rituximab. The results showed that chemotherapy resulted in an overall response rate of 100%, 3 patients in stage IE were in partial remission (PR), 5 patients in stage IV were in complete remission (CR). After a median follow-up of 21 months, 3 patients in stage IE were still in PR status, 5 patients in stage IV were still in CR status, and no relapses or disease progression were observed. It is concluded that the first-line chemotherapy has been confirmed to be effective and well tolerated in patients with localized ocular adnexal MALT lymphoma. Rituximab combined with chemotherapy can increase remission rate, it is feasible option as first-line treatment for ocular adnexal MALT lymphoma.
Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Eye Neoplasms ; drug therapy ; Female ; Humans ; Lymphoma, B-Cell, Marginal Zone ; drug therapy ; Male ; Middle Aged

Orbital metastasis from hepatocellular carcinoma is very rare, with only 14 biopsy-proven cases from hepa tocellular carcinoma cases reported in English literature and three cases reported in Korea. Common symptoms of orbital metastasis are proptosis, visual loss, ocular pain and oculomotor dysfunction. For its precise diagnosis, we can perform fine needle aspiration biopsy, orbit CT or MRI, and ultrasonography. Radiotherapy is the mainstay in the treatment of orbital metastasis. In addition, chemotherapy, hormonal therapy and surgical intervention can play a role in the treatment of orbital metastasis according to the primary cancer and symptoms. However, the prognosis of orbital metastasis is poor. We report herein a rare case of a patient with orbital metastasis from hepatocellular carcinoma, which was treated with various modalities that included resection, and who had good clinical and radiological responses to radiation therapy and sorafenib (Nexavar, Bayer HealthCare).
Biopsy ; Biopsy, Fine-Needle ; Carcinoma, Hepatocellular* ; Diagnosis ; Drug Therapy ; Exophthalmos ; Eye Neoplasms ; Humans ; Korea ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Orbit* ; Prognosis ; Radiotherapy ; Ultrasonography

PURPOSE: To report two cases of abducens nerve palsy that occurred after the administration of chemotherapeutic agents. CASE SUMMARY: (Case 1) A 49-year-old woman with breast cancer presented with acute onset of diplopia 6 weeks after the beginning of combination chemotherapy with cyclophosphamide, doxorubicin, and paclitaxel. She had a left esotropia of 30 prism diopters (PD) with a mild decrease in abduction of the left eye. She was diagnosed with left abducens nerve palsy. (Case 2) A 29-year-old man with non-Hodgkin's lymphoma presented with diplopia 7 weeks after beginning combination chemotherapy including cyclophosphamide, adriamycin, vincristine, and prednisolone. He had a 20PD esotropia in the primary position with a slight decrease in abduction of both eyes. He was diagnosed with bilateral abducens nerve palsy. The chemotherapy regimen of both patients was changed, and they were followed up without treatment. In case 1, diplopia improved 2 months after change of chemotherapy regimen with complete recovery within 4 months. In case 2, diplopia improved 2 months after a change of chemotherapy regimen with complete recovery within 3 months.
Abducens Nerve ; Abducens Nerve Diseases ; Adult ; Breast Neoplasms ; Cyclophosphamide ; Diplopia ; Doxorubicin ; Drug Therapy, Combination ; Esotropia ; Eye ; Female ; Humans ; Lymphoma, Non-Hodgkin ; Middle Aged ; Paclitaxel ; Prednisolone ; Vincristine

PURPOSE: To assess the clinical pattern, the histopathological findings, the response to treatments, the recurrence pattern and the prognosis of malignant lymphoma in the ocular adnexa. METHODS: This study was performed on 22 total eyes from 17 patients who were diagnosed with ocular adnexal malignant lymphoma. We retrospectively analyzed the medical records for patient information including the histological classification based on age, the gender of each patient, the symptoms and signs at the initial diagnosis, the presence of binocular invasion, the findings of the surgical biopsy, the clinical stage of each patient's tumor, and the treatment methods used and their effectiveness. The mean follow-up period was 24.8 months. RESULTS: The mean age of patients studied was 46.8 years old. Six females and 11 males were included in the study. Fifteen cases consisting of 20 total eyes represented extranodal marginal zone B cell lymphoma of mucosa-associated lymphoid tissue (MALT). Five of seven patients (71.4%) whose lymphoma occurred within the conjunctiva relapsed after irradiation or chemotherapy, and four of the relapsed patients were salvaged with further therapy. CONCLUSIONS: Extranodal marginal zone B cell lymphoma of mucosa-associated lymphoid tissue (MALT) constituted 88.2% of all lymphomas involving the ocular adnexa. Lymphoma in the ocular adnexa responded well to conventional treatment, but the recurrence rate of lymphoma in the conjunctiva was significantly high.
Treatment Outcome ; Retrospective Studies ; Neoplasm Recurrence, Local ; Middle Aged ; Male ; Lymphoma, Mucosa-Associated Lymphoid Tissue/drug therapy/*pathology/radiotherapy/surgery/*therapy ; Humans ; Follow-Up Studies ; Female ; Eye Neoplasms/drug therapy/*pathology/radiotherapy/surgery/*therapy ; Combined Modality Therapy ; Biopsy ; Aged, 80 and over ; Aged ; Adult

A 43-year-old male presented with a painless left testicular mass. The pathologic diagnosis of the radical orchiectomy specimen was peripheral T-cell lymphoma, unspecified (PTCL-u). According to the Ann Arbor staging system, his initial stage was III because of the right nasopharyngeal involvement. After first-line chemotherapy with four courses of the CHOP regimen and this was followed by involved-field radiotherapy, he achieved complete remission. Two months later, disease recurred to the left ciliary body of the left eye without evidence of involvement at other sites. Although the patient received intensive chemotherapy with autologous hema-topoietic stem cell transplantation, he ultimately died of leptomeningeal seeding. Because both the central nervous system (CNS) and the orbit are sanctuary sites for chemotherapy, orbital infiltration of lymphoma should prompt physicians to evaluate involvement of the CNS and to consider performing prophylactic intrathecal chemotherapy as a treatment option.
Adult ; Central Nervous System ; Ciliary Body ; Diagnosis ; Drug Therapy ; Eye Neoplasms ; Humans ; Lymphoma ; Lymphoma, Non-Hodgkin ; Lymphoma, T-Cell* ; Lymphoma, T-Cell, Peripheral ; Male ; Orbit* ; Orchiectomy ; Radiotherapy ; Recurrence* ; Stem Cell Transplantation ; T-Lymphocytes* ; Testis