Smooth muscle tumor of the uveal tract is rare, and mostly located in the ciliochoroidal area. We report a unique case of posterior choroidal leiomyoma in a 27-yr-old man. Ophthalmoscopic examination disclosed an 11 mm-sized mass on the fundus two-disc diameters apart from the optic disc. With a suspicion of amelanotic melanoma, the globe was enucleated. The mass occupied the whole thickness of choroidal stroma beneath the pigmented retinal epithelium and composed of spindle cells arranged in intersecting fascicles. Immunohistochemical studies demonstrated immunoreactivities of the tumor cells for smooth muscle actin, desmin, and vimentin. Ultrastructurally, numerous intracytoplasmic filaments with fusiform focal densities, scattered segmental external laminae, subplasmalemmal densities, and pinocytic vesicles were noted. The leiomyoma in this case had several unusual features in that it was confined to the posterior choroid with no relation to the ciliary body, occupied the whole stroma of the choroid instead of suprauveal location, and occurred in a young male. It is important to include choroidal leiomyoma in the differential diagnosis of choroidal tumors.
Actins/analysis ; Adult ; Choroid Neoplasms/chemistry/*pathology ; Desmin/analysis ; Humans ; Leiomyoma/chemistry/*pathology ; Male ; Uveal Neoplasms/chemistry/*pathology ; Vimentin/analysis

Acute Disease ; Adult ; Choroid Neoplasms ; surgery ; Female ; Humans ; Male ; Melanoma ; surgery ; Middle Aged ; Pulmonary Embolism ; etiology ; Uveal Neoplasms ; surgery

Adenocarcinoma ; pathology ; Ciliary Body ; Humans ; Iris Neoplasms ; pathology ; Lung Neoplasms ; pathology ; Male ; Middle Aged ; Uveal Neoplasms ; pathology

We report a case of ciliary body melanocytoma in a Korean patient, which presented as an intermittently painful pigmented iris mass and was successfully managed by iridocyclectomy. A 52-year-old healthy man presented with an irregularly-shaped and heavily-pigmented mass at the iris root of his right eye. Visual acuity of the right eye was 20/20 with normal intraocular pressure. Ultrasound biomicroscopy showed a 1.5x1.3-mm ciliary-body mass with extension into the iris root. Iridocyclectomy with scleral resection under a lamellar scleral flap was performed, and the histopathologic features of the resected tissue were consistent with melanocytoma of the ciliary body. The patient's visual acuity remained 20/20 with good postoperative cosmesis. During one year of follow-up, no signs of tumor recurrence were seen, and the patient reported resolution of the intermittent ocular pain in the involved eye.
*Ciliary Body/surgery ; Humans ; Iris/*pathology/*physiopathology/surgery ; Male ; Middle Aged ; Neoplasm Invasiveness/*pathology/physiopathology ; Nevus/*pathology/surgery ; Pain/*physiopathology ; Uveal Neoplasms/*pathology/surgery

OBJECTIVETo study the pathological features of uveal melanoma and to evaluate their influence on patients' prognosis.

METHODSParaffin embedded uveal melanoma tissues of 115 cases were examined using routine pathologic methods. Three histological types were classified according to the modified Callender system and patients were followed clinically. The data were done regression and survival analysis by SPSS statistic soft.

RESULTSThe patient with epithelial cell type, mixed type, and spindle cell type uveal melanoma have different life times, the average life time is 35.6 +/- 21.5 months, 63.7 +/- 37.0 months, 69.5 +/- 36.5 months in turn, patients with epithelial uveal melanoma had shorter survival time than other two types. The survival time was negatively related to the largest diameter of contact area with the sclera, the largest height and the depth of tumor invasion to the sclera.

CONCLUSIONSEpithelial uveal melanoma is more malignant than the other two types. Histological classification of this tumor combined with other pathologic features can indicate the patient's prognosis.

Eye Neoplasms ; mortality ; pathology ; Humans ; Melanoma ; mortality ; pathology ; Prognosis ; Survival Rate ; Uveal Neoplasms ; mortality ; pathology

Adenocarcinoma ; pathology ; Aged ; Ciliary Body ; pathology ; Epithelium ; pathology ; Female ; Humans ; Uveal Neoplasms ; pathology

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

PURPOSE: To investigate the epidemiologic and clinical features of uveal melanomas in Korean patients. METHODS: The medical records of 35 patients (35 eyes) with the diagnosis of uveal melanoma between September 2004 and December 2006 were reviewed retrospectively. RESULTS: Of the 35 patients, 22 were males (62.9%) and 13 were females (37.1%), with a mean age at diagnosis of 48.2+/-14.1 years (range, 24-82 years). Decreased visual acuity was the most common symptom in 23 patients (65.7%), while 6 patients (17.1%) were detected without prior symptoms. The shape of the uveal melanoma was dome-shaped in 27 eyes (77.1%) and mushroom-shaped in 8 eyes (22.9%). The mean largest basal diameter of the tumors was 9.0+/-3.3 mm (2.4-19.0 mm), and the mean apical height was 6.2+/-2.6 mm (1.1-13.0 mm). The tumors were classified according to their size; a small melanoma was found in 4 eyes (11.4%), a medium melanoma in 29 eyes (82.9%), and a large melanoma in 2 eyes (5.7%). CONCLUSIONS: Uveal melanomas manifest earlier in Korean patients than in Caucasian patients. At the time of diagnosis, 33 eyes (94.3%) had small or medium melanomas that could be treated.
Eye ; Female ; Humans ; Male ; Medical Records ; Melanoma ; Retrospective Studies ; Uveal Neoplasms ; Visual Acuity

OBJECTIVETo evaluate the clinical value of stereotactic radiosurgery (SRS) for uveal melanoma.

METHODSFrom Jan, 1996 to March, 2004, 16 patients with uveal melanoma were treated with SRS, two by one session (35 Gy, 25 Gy) and fourteen by fractionated SRS (30-55 Gy/2-4F/4-16D). The follow-up period ranged from 3 to 100 months (median: 66 months).

RESULTSAll 16 patients were still alive though all were blind in the diseased eye during recent follow-up. Local control rate was 93.4%, 5-year survival rate of 13 patients who have been followed for more than 5 years, was 100% (13/13). However, 7 patients received eyeball enucleation due to corneal ulcer (n = 2), suspicion for uncontrolled tumor (n = 2) and secondary glaucoma (n = 3). One patient developed distant metastasis, though still alive.

CONCLUSIONFractionated radiosurgery is safe and effective for uveal melanoma. It is indicated for lesions of limited size (longest diameter < 20 mm, depth < 15 mm) located in the posterior pole or behind the equator at the back of the eyeball.

Adult ; Aged ; Eye Enucleation ; methods ; Female ; Humans ; Male ; Melanoma ; surgery ; Middle Aged ; Radiosurgery ; Stereotaxic Techniques ; Uveal Neoplasms ; surgery

BACKGROUNDLocal resection is an effective method for treating the uveal melanoma. The aim of this study is to evaluate the survival and clinical outcomes of patients with uveal melanoma treated by local resection or enucleation.

METHODSTotally, 167 consecutive patients with uveal melanoma were recruited for the study, of whom 57 patients were treated with local resection and 110 patients were treated with enucleation. The main outcome was measured by the visual acuity, local recurrence, eye retention, metastases, and melanoma-related mortality.

RESULTSThere were statistically significant differences in the largest basal diameter of the tumor (t = -3.441), the tumor thickness (t = -4.140), the ciliary body infiltration (χ(2) = 8.391), and the duration of follow-up (Z = 3.995) between the two groups (P < 0.05). The univariate survival analysis showed that the method of treatment was not significantly associated with metastases. The Cox proportion hazard analysis showed that the risk factors for metastasis involved the age at the time of diagnosis (RR = 1.752, 95% CI 1.066-2.880, P = 0.027), the largest basal diameter of the tumor (RR = 3.508, 95% CI 1.934-6.336, P = 0.000), and the histological type (RR = 2.444, 95% CI 1.106-5.877, P = 0.046). The 5-year metastases rate was 18.60% for the group with local resection and 27.81% for enucleation (χ(2) = 1.214, P > 0.05); the 5-year melanoma-related mortality was 16.27% for the group with local resection and 25.33% for enucleation (χ(2) = 1.304, P > 0.05). The 5-year local tumor recurrence rate was 29.50% and the 5-year accumulated eye retention rate was 69.00% after local resection. The visual acuity which light perception or better of 60 months after local resection was observed in 25 (92.60%) among persons retaining eye.

CONCLUSIONSThe survival outcomes of the patients with local resection were not worse than that of the patients with enucleation, and local resection could make the patient retain eye and partial visual functions. Hence, local resection may be an effective method for patients with uveal melanoma eligible for operation.

Adult ; Eye Enucleation ; methods ; Female ; Humans ; Male ; Melanoma ; surgery ; Treatment Outcome ; Uveal Neoplasms ; surgery ; Visual Acuity ; physiology