Adenoma ; diagnosis ; pathology ; Female ; Humans ; Middle Aged ; Pigment Epithelium of Eye ; pathology ; Uveal Neoplasms ; diagnosis ; pathology

PURPOSE: To investigate various imaging techniques for the diagnosis of primary uveal melanomas in Korean patients. METHODS: We retrospectively reviewed the medical records of 35 eyes in 35 patients (22 males, 13 females) diagnosed with uveal melanomas between September 2004 and December 2006. The findings of fundus photographs, ultrasonography, CT scan, MRI, and PET scan were documented. RESULTS: A/B scan ultrasonography showed typical findings of uveal melanomas in 74.3% (26 eyes) of the patients. On CT scan, the mass appeared as a homogenous hyperdense lesion, and on MRI, the typical signal of hyperintensity on the T1-weighted image and hypointensity on the T2-weighted image was seen in 89.3% (25 eyes), with contrast enhancement in only 46.4% (13 eyes) of the patients. A PET scan revealed positive tumor uptake in 22.7% (5 eyes) of the patients. CONCLUSIONS: Although ultrasonography is the most useful and accurate method for the diagnosis of uveal melanoma, it provides more atypical cases in Korean patients than Caucasian patients. CT scans and MRI can be used for a differential diagnosis, but the diagnostic efficacy of PET scans is low.
Diagnosis, Differential ; Eye ; Humans ; Magnetic Resonance Imaging ; Male ; Medical Records ; Melanoma ; Positron-Emission Tomography ; Retrospective Studies ; Uveal Neoplasms

BACKGROUNDCiliary body tumors are usually difficult to diagnose and treat in early stages. However, treatment of such tumors has trended toward ocular conservation instead of enucleation. Local excision of ciliary body tumors has become effective with the development of the modern vitrectomy, but long-term outcomes are still not clear. Therefore, we reported the outcome of locally excised ciliary body tumors after long-term follow-up.

METHODSTwenty-two patients (22 eyes), who had been diagnosed with ciliary body tumors in Beijing Tongren Hospital from January 1996 to June 2001, were enrolled in this prospective cohort study. Localized lamellar sclera-ciliary excisions were performed. In some cases, vitrectomies, scleral graft transplantations, and further excisions of the anterior choroid were performed. Diagnoses were confirmed by histopathologic examination. Patients were followed from five to eleven years after surgery. Their visual acuity, intraocular pressure and local recurrence were recorded with descriptive percentages.

RESULTSAfter surgery, all patients maintained normal eyeball appearances. Six patients maintained circular pupils. The final best corrected visual acuities (BCVA) varied from 0.02 - 1.00, including 18 patients (81.82%) who had BCVA equal to or better than that before surgery. Fifteen patients (68.18%) had BCVA better than 0.3. Only two patients had intraocular pressure (IOP) of less than 10 mmHg and the other patients maintained normal IOP. Nine cases (40.91%) were given confirmed diagnosis of malignant melanoma, four (18.18%) of melanocytoma, six (27.27%) of nonpigmented ciliary epithelial adenoma, two (9.09%) of neurofibroma, and one (4.55%) of neurinoma. Twenty patients (90.91%) had no recurrence during the follow-up period. In one case melanocytoma recurred seven years after surgery and enucleation was performed. One patient, whose operation removed a malignant melanoma with a diameter of 16 mm, died of hepatic metastasis five years after the operation.

CONCLUSIONFor some ciliary body tumors, especially in the early stages, local excision is an effective and safe method to save the vision and the eyeball.

Adolescent ; Adult ; Ciliary Body ; Cohort Studies ; Female ; Humans ; Intraocular Pressure ; Male ; Melanoma ; surgery ; Middle Aged ; Prospective Studies ; Uveal Neoplasms ; diagnosis ; pathology ; surgery ; Visual Acuity

No abstract available.
Follow-Up Studies ; Humans ; Limbus Corneae/*diagnostic imaging ; Magnetic Resonance Imaging ; Male ; Melanoma/*diagnosis ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Positron-Emission Tomography ; Time Factors ; Tomography, X-Ray Computed ; Uveal Neoplasms/*diagnosis

A 19-yr-old woman with a previous history of a mass of the right ciliary body presented with a decreased visual acuity of right eye. Clinicoradiologic examinations suggested a recurrent mass of the ciliary body. Enucleation of the right eye was performed under the impression of malignant tumor. On microscopic examination, the tumor was a mesectodermal leiomyoma of the ciliary body. On immunohistochemistry, the tumor cells were reactive to smooth muscle actin and vimentin, but not reactive to cytokeratin, S-100 protein, neurofilament, desmin, epithelial membrane antigen, HMB-45, glial fibrillary acidic protein, and synaptophysin. Electron microscopy revealed numerous thin longitudinally placed myofilaments and focal densities in the cytoplasms. In the review of the literature, only 27 cases of mesectodermal leiomyoma of the ciliary body were reported, however, there was no report of recurrent cases. Mesectodermal leiomyoma should be differentiated from other orbital spindle-cell tumors such as amelanotic melanomas and glial tumors. Immunohistochemical and electron microscopic studies may be useful for the correct diagnosis by showing smooth muscle differentiation in the tumor cells.
Actins/biosynthesis ; Adult ; Cell Differentiation ; Ciliary Body/*pathology ; Cytoplasm/metabolism ; Female ; Human ; Immunohistochemistry ; Leiomyoma/*diagnosis/*pathology ; Microscopy, Electron ; Myocytes, Smooth Muscle/metabolism ; Recurrence ; Uveal Neoplasms/*diagnosis/pathology ; Vimentin/biosynthesis