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Yue H, Xu B, Gao J, Bi Y, Xue K, Guo J, Zhang R, Ren H, Yuan Y, Qian J. A Novel and Easy-to-Promote Prognostic Model for Patients With Uveal Melanoma. Front Oncol 2022; 12:879394. [PMID: 35719929 PMCID: PMC9201029 DOI: 10.3389/fonc.2022.879394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose To establish an easy and widely applicable prognostic prediction model for uveal melanoma (UM) based on a Chinese population. Patients and Methods A total of 295 consecutive cases treated at the Eye & ENT Hospital of Fudan University were included as the primary cohort, and 256 cases were included in the validation cohorts from two external Caucasian databases. Clinicopathological data were collected retrospectively, and nomogram models were formulated based on multivariable analysis. The concordance index (C-index), AUC (area under the Receiver Operating Characteristic, ROC curve), and Brier score were calculated and compared. Results Based on the training cohort, a nomogram model was established with five relevant variables: age, tumor size, ciliary body involvement, non-spindle cell type and extra-scleral extension. The C-index was 0.737, the 3- and 5-year AUCs were 0.767 and 0.742, and the Brier scores for 3- and 5-year survival were 0.082 and 0.129, respectively, which showed superior prediction compared to that of the Tumor, Node and Metastasis staging system. The model also displayed good discrimination and calibration in the external validation cohorts. By risk stratification, patients could be divided into low- and high-risk groups, and the overall survival curves displayed significant differences in the training and validation cohorts. Conclusion Our nomogram model was simple and accurate at predicting the overall survival of patients with UM. It was established based on Asian patients and proved suitable for Caucasian patients; thus, it has a wide range of potential applications, especially for patients living in less medically developed countries and regions.
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Affiliation(s)
- Han Yue
- Department of Ophthalmology, Eye & Ear, Nose, and Throat (ENT) Hospital of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
| | - Binbin Xu
- Department of Ophthalmology, Eye & Ear, Nose, and Throat (ENT) Hospital of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
| | - Jian Gao
- Center of Clinical Epidemiology and Evidence-based Medicine, Fudan University, Shanghai, China
| | - Yingwen Bi
- Department of Pathology, Eye & Ear, Nose, and Throat (ENT) Hospital of Fudan University, Shanghai, China
| | - Kang Xue
- Department of Ophthalmology, Eye & Ear, Nose, and Throat (ENT) Hospital of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
| | - Jie Guo
- Department of Ophthalmology, Eye & Ear, Nose, and Throat (ENT) Hospital of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
| | - Rui Zhang
- Department of Ophthalmology, Eye & Ear, Nose, and Throat (ENT) Hospital of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
| | - Hui Ren
- Department of Ophthalmology, Eye & Ear, Nose, and Throat (ENT) Hospital of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
| | - Yifei Yuan
- Department of Ophthalmology, Eye & Ear, Nose, and Throat (ENT) Hospital of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
| | - Jiang Qian
- Department of Ophthalmology, Eye & Ear, Nose, and Throat (ENT) Hospital of Fudan University, Shanghai, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, China
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Jha J, Singh MK, Singh L, Pushker N, Lomi N, Meel R, Chosdol K, Sen S, Bakhshi S, Kashyap S. Association of TYRP1 with hypoxia and its correlation with patient outcome in uveal melanoma. Clin Transl Oncol 2021; 23:1874-1884. [PMID: 33811629 DOI: 10.1007/s12094-021-02597-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 03/12/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Molecular mechanisms of uveal melanoma development in association with high pigmentation are unclear. Tyrosinase Related Protein (TYRP1) is not only one of the important melanogenesis marker that contributes to melanin synthesis, but can also prevents the melanocyte death. The induction of melanogenesis leads to induction of HIF-1α which can affect the behavior of melanoma cells and its surrounding environment. The aim of our study was to determine the expression of TYRP1 and HIF-1α at the protein and RNA level and determine its prognostic significance. METHODS In the present study, the expression of TYRP1 and HIF-1α was investigated on 61 formalin-fixed paraffin-embedded choroidal melanoma samples by immunohistochemistry. Fresh 50 samples were validated by real-time PCR. Results were correlated with clinicopathological parameters and Kaplan-Meier was performed to determine the prognostic significance. RESULTS High immunoexpression of TYRP1 and HIF-1α was present in 61 and 54% of patients, respectively. Both TYRP1 and HIF-1α correlated well with high pigmentation and BAP1 (BRCA1 Associated Protein-1) loss (p < 0.05) at IHC level as well as transcriptional level. There was reduced metastatic free survival in patients with necrosis and this was statistically significant (p = 0.010). CONCLUSION Our findings indicate that TYRP1 can be used as a potential biomarker in the development of targeted therapy in UM. Further studies on melanogenesis markers associated with TYRP1 could provide us a better understanding in this field.
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Affiliation(s)
- J Jha
- Department of Ocular Pathology, Dr.R.P.Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - M K Singh
- Department of Dermatology, University of Wisconsin, Madison, USA
| | - L Singh
- Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - N Pushker
- Department of Ophthalmology, Dr.R.P.Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - N Lomi
- Department of Ophthalmology, Dr.R.P.Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - R Meel
- Department of Ophthalmology, Dr.R.P.Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - K Chosdol
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - S Sen
- Department of Ocular Pathology, Dr.R.P.Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - S Bakhshi
- Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
| | - S Kashyap
- Department of Ocular Pathology, Dr.R.P.Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
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Manchegowda P, Singh AD, Shields C, Kaliki S, Shah P, Gopal L, Rishi P. Uveal Melanoma in Asians: A Review. Ocul Oncol Pathol 2021; 7:159-167. [PMID: 34307326 DOI: 10.1159/000512738] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 11/02/2020] [Indexed: 12/22/2022] Open
Abstract
Despite limited data, some differences in the clinical profile can be observed in Asian population when compared with presentation of uveal melanoma (UM) in white population. The incidence of UM is higher in Whites than in Asians. For the purpose of comparison with Asian population, data from North America, Europe, and Australia were considered as that of "white" population. The annual incidence of UM has been reported to be 5-6 cases/million in whites. The incidence in different parts of Asia is estimated at 0.2-0.6 per million. The age of presentation is around 40-55 years in Asians, which is younger when compared to that of whites (mean age of 58 years). At presentation, mean basal diameter of tumors in Asians is greater compared to whites but overall, medium-size tumors are most common. Clinical presentation is straightforward in majority of cases with retinal detachment, acute glaucoma, uveitis, cataract, or vitreous hemorrhage as common symptoms. Epithelioid cell-type variant carries the worst prognosis. Management options for choroidal melanoma include transpupillary thermotherapy, plaque radiotherapy, charged particle irradiation, local resection, enucleation, or orbital exenteration. Most commonly used modalities are enucleation and plaque radiotherapy.
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Affiliation(s)
- Pradeep Manchegowda
- Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, India
| | - Arun D Singh
- Ophthalmic Oncology, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Carol Shields
- Ocular Oncology Service, Wills Eye hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Swathi Kaliki
- LV Prasad Eye Institute, Ocular Oncology Service, The Operation Eyesight Universal Institute of Eye Cancer, Hyderabad, India
| | - Parag Shah
- Department of Pediatric Retina & Ocular Oncology, Aravind Eye Hospital & Post Graduate Institute of Ophthalmology, Coimbatore, India
| | - Lingam Gopal
- Department of Ophthalmology, National University Hospital, Singapore, Singapore
| | - Pukhraj Rishi
- Truhlsen Eye Institute, University of Nebraska Medical Centre, Omaha, Nebraska, USA
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Meeralakshmi P, Shah PK, Narendran V. Experiences of two different modalities in the management of choroidal melanoma in the Asian Indian population. South Asian J Cancer 2020; 6:134-136. [PMID: 28975125 PMCID: PMC5615886 DOI: 10.4103/sajc.sajc_160_16] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Choroidal malignant melanoma is a rare intraocular cancer in Asian Indian population. There is a paucity of data from our population comparing iodine 125 (I-125) brachytherapy and enucleation. AIM This study aims to compare two groups of choroidal melanoma patients treated with either I-125 brachytherapy or enucleation in the Asian Indian population. OBJECTIVES To evaluate the long-term morbidity and mortality rates in choroidal melanoma patients treated with either I-125 brachytherapy or enucleation. METHODS It is a retrospective study involving forty four eyes, diagnosed with choroidal melanoma from May 2008 to February 2015. All were evaluated preoperatively for metastasis. Twenty-two underwent globe salvaging I-125 brachytherapy surgery whereas remaining 22 underwent globe destructive primary enucleation procedure. RESULTS At a mean follow-up 39 months, 2 of 22 cases (9%) died in the brachytherapy group. One was secondary to metastasis in the liver while the other case died of a natural cause. In the enucleation group also, there were two deaths (9%) secondary to metastasis. The metastasis free survival was 95% in the brachytherapy group and 91% in the enucleation group, which was not statistically significant (P = 0.3577). Kaplan-Meier survival at 3 years and 5 years was 95% and 89% for brachytherapy group and 94% and 89% for enucleation group. CONCLUSION This study found no difference in the long-term survival of choroidal melanoma patients treated with either brachytherapy or enucleation in the Asian Indian eyes.
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Affiliation(s)
- Prajna Meeralakshmi
- PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
| | - Parag K Shah
- Department of Pediatric Retina and Ocular Oncology, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India
| | - Venkatapathy Narendran
- Department of Pediatric Retina and Ocular Oncology, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Coimbatore, Tamil Nadu, India
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Rao R, Honavar SG, Mulay K. Multifocal choroidal melanoma in oculodermal melanocytosis in an Asian Indian. Indian J Ophthalmol 2020; 67:2089-2091. [PMID: 31755471 PMCID: PMC6896527 DOI: 10.4103/ijo.ijo_1773_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
A 51-year-old Asian Indian male with right oculodermal melanocytosis presented with a blurred visual acuity of 20/40. Upon fundus examination, he was discovered to have two independent pigmented choroidal melanomas in the temporal juxtapapillary region and inferiorly, in the region of trace clinical sectoral choroidal melanocytosis. The patient underwent enucleation, and on histopathology the two tumors were found to be in the area of choroidal melanocytosis, in continuity with each other. Multifocal choroidal melanoma is an exceedingly rare diagnosis. Ocular melanocytosis is a known predisposing factor for both unifocal and multifocal melanomas. Lifelong monitoring for uveal melanomas must be done in all patients with ocular melanocytosis.
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Affiliation(s)
- Raksha Rao
- Ocular Oncology Service, National Retinoblastoma Foundation, Centre for Sight, Hyderabad, Telangana, India
| | - Santosh G Honavar
- Ocular Oncology Service, National Retinoblastoma Foundation, Centre for Sight, Hyderabad, Telangana, India
| | - Kaustubh Mulay
- Ocular Pathology Service, National Retinoblastoma Foundation, Centre for Sight, Hyderabad, Telangana, India
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Posterior uveal melanoma in 321 Asian Indian patients: analysis based on the 8th edition of American Joint Committee Cancer classification. Int Ophthalmol 2020; 40:3087-3096. [PMID: 32601966 DOI: 10.1007/s10792-020-01494-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 06/22/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE To evaluate the presenting features, treatment, and outcomes of posterior uveal melanoma (PUM) in Asian Indians based on the 8th edition of American Joint Committee on Cancer (AJCC) classification. METHODS Retrospective interventional case series of 321 Asian Indian patients with PUM. RESULTS Based on AJCC, PUM was classified into categories T1 (n = 36; 11%), T2 (n = 74; 23%), T3 (n = 126; 39%), and T4 (n = 85; 27%). Regarding tumor features, T4 was more likely to have pre-equatorial epicenter (vs T1 and T2; p ≤ 0.011), iris abnormalities (vs T2 and T3; p ≤ 0.002), and extraocular tumor extension (vs T3; p = 0.001), whereas T1 was more likely to have macular epicenter (vs T2, T3, T4; p ≤ 0.013), lipofuscin deposits (vs T3 and T4; p ≤ 0.008), and amelanotic tumors (vs. T4; p = 0.003). On multivariate analysis, factors predictive of systemic metastasis were increasing tumor thickness (p = 0.002) and extraocular tumor extension (p = 0.009). The 5-, 10-, and 15-year melanoma-related metastases rates were 0%, 0%, and 0% in T1, 0%, 60%, and 60% in T2, 7%, 40%, and 70% in T3 and 13%, 36%, and 76% in T4, respectively. Risk for metastasis was 1.23 times more for every 1-mm increase in tumor thickness and 9 times more with extraocular tumor extension. CONCLUSION The AJCC 8th edition provides prognostic classification for PUM in Asian Indian patients. The significant risk factors for metastasis were increasing tumor thickness and extraocular tumor extension.
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Jha J, Singh MK, Singh L, Pushker N, Bajaj MS, Sen S, Kashyap S. Prognostic relevance of ATM protein in uveal melanoma and its association with clinicopathological factors. Int J Clin Oncol 2019; 24:1526-1535. [PMID: 31377937 DOI: 10.1007/s10147-019-01519-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 07/25/2019] [Indexed: 12/19/2022]
Abstract
PURPOSE Uveal melanoma (UM) is an intraocular malignancy commonly arising from choroid which can cause visual loss or metastasis. Ataxia-telangiectasia mutated (ATM) protein is an activator of DNA damage response and its role in uveal melanoma (UM) is still unexplored. Therefore, the study aims to detect the expression and localization of ATM protein and its association with clinicopathological parameters METHODS: Expression of nuclear ATM (nATM) was investigated on 69 formalin fixed paraffin embedded choroidal melanoma samples by immunohistochemistry and validated by western blotting. Results were then correlated with clinical and histopathological parameters. Prognostic significance was determined by the Kaplan-Meier analysis and the multivariate analysis by Cox's hazard proportional method. RESULTS Loss of nATM was observed in 65% of cases, which was statistically significant with the reduced disease-free survival (p = 0.042). This loss was more frequently found in cases with high-risk histopathological factors like epithelioid cell type, tumor infiltrating lymphocytes and high pigmentation which might help in the progression of melanoma. On multivariate analysis, extraocular spread and loss of nATM were found to be independent prognostic factors (p < 0.05). CONCLUSION Our data suggest that loss of nATM protein might serve as a poor prognostic marker in the pathogenesis of uveal melanoma which may lead to increased risk of metastasis.
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Affiliation(s)
- Jayanti Jha
- Department of Ocular Pathology, Dr. R.P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Mithalesh Kumar Singh
- Department of Ocular Pathology, Dr. R.P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Lata Singh
- Department of Biosciences, JMI, New Delhi, India
| | - Neelam Pushker
- Department of Ophthalmology, Dr. R.P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Mandeep Singh Bajaj
- Department of Ophthalmology, Dr. R.P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Seema Sen
- Department of Ocular Pathology, Dr. R.P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Seema Kashyap
- Department of Ocular Pathology, Dr. R.P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
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Does NEMO/IKKγ protein have a role in determining prognostic significance in uveal melanoma? Clin Transl Oncol 2018; 20:1592-1603. [PMID: 29796997 DOI: 10.1007/s12094-018-1895-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 05/11/2018] [Indexed: 01/08/2023]
Abstract
PURPOSE Uveal melanoma, although a rare form of cancer, is the most common primary malignancy of the eye in adults. Nuclear factor-κB (NF-κB) is a transcription factor that transactivates genes involved in the regulation of cell growth, apoptosis, angiogenesis, and metastasis, but the molecular mechanisms that negatively regulate NF-κB activation are not fully understood. NF-κB can also be activated by DNA damage pathway through NEMO protein. Therefore, the objective of this study is to elucidate the role of NEMO/IKKγ protein in uveal melanoma patients. METHODS Seventy-five formalin-fixed paraffin-embedded prospective tissues of uveal melanoma were included in the present study. These cases were reviewed and investigated for the expression of NEMO/IKKγ protein by immunohistochemistry and validated by western blotting along with the qRT-PCR for mRNA expression. Expression levels were correlated with the clinicopathological parameters and patients' outcome. RESULTS Immunohistochemistry showed cytoplasmic expression of NEMO/IKKγ expression in only 22 out of 75 (29.33%) cases. This result was confirmed by western blotting, and correlated well with the immunohistochemical expression of NEMO/IKKγ protein (48 kDa). In addition, downregulation of this gene was found in 87.93% of the cases when compared with the normal tissues. On statistical analysis, loss of NEMO/IKKγ protein was correlated with neovascularization, high mitotic count, and presence of vascular loop (p < 0.05). There was less overall survival rate with low expression of NEMO/IKKγ protein in patients with uveal melanoma. CONCLUSION This was the first study suggesting the relevant role of NEMO/IKKγ protein, and highlights the prognostic significance with outcome in uveal melanoma patients. This protein might be used as a screening biomarker in these patients after large-scale validation and translational studies.
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Pal BP, Garge S, Khetan V. Choroidal melanoma: A short review with an Indian perspective. Oman J Ophthalmol 2017; 10:135-144. [PMID: 29118486 PMCID: PMC5657153 DOI: 10.4103/ojo.ojo_234_2016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Choroidal melanoma (CM), the most common intraocular tumor in adults, is still a rarity in Asia. Having a high propensity for metastasis with a poor survival, recognizing it early is essential. Although it has typical clinical features, there are instances of simulating lesions. Fine-needle aspiration biopsy can be a valuable tool not only to confirm our clinical suspicion but also aid in prognosticating it. From days of histopathological prognostic markers, we are moving on to genetic markers which are reliably providing insights, helping us in providing a better care for our patients. Eye preservation has taken an all new important meaning in CM with many centers opting for different modalities of radiation. Herein, we try to provide a short synopsis of CM looking into its epidemiology, clinical features, diagnosis, and management. We also look briefly into the role of fine-needle biopsy in managing CM. Being a tertiary referral ocular center in India, we do come across CM; we have shared the preliminary reports of our analysis of managing CM over a 9-year period.
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Affiliation(s)
- Bikramjit P. Pal
- Department of Vitreoretina, Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Saili Garge
- Department of Vitreoretina, Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Vikas Khetan
- Department of Vitreoretina, Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
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Yan L, He G, Zhou X, Zheng Y, Zhu Y, Yang J, Zhang M, Zhou Y. Contrast-enhanced ultrasound in the diagnosis of orbital space-occupying lesions. Clin Radiol 2017; 72:798.e1-798.e6. [PMID: 28464984 DOI: 10.1016/j.crad.2017.03.026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 02/22/2017] [Accepted: 03/30/2017] [Indexed: 12/29/2022]
Abstract
AIM To summarise the sonographic findings and assess the feasibility of contrast-enhanced ultrasound (CEUS) as an imaging method for the diagnosis of orbital space-occupying lesions. MATERIALS AND METHODS This was a prospective study of 53 patients who underwent orbital ultrasound at Xijing Hospital. Two-dimensional ultrasound, colour Doppler flow imaging (CDFI), and CEUS imaging were obtained and compared in patients with orbital haemangioma, pseudotumour, melanoma of the choroid, and retinoblastoma. RESULTS CEUS imaging cannot only visualise the location, shape, border, acoustic properties of a lesion, and interactions between the lesion and surrounding tissues, but also display the microvasculature and tissue perfusion within the lesion. The information obtained from CEUS imaging is valuable for diagnosis and differential diagnosis of orbital space-occupying lesions. CONCLUSION CEUS imaging allowed better visualisation of the lesions, enabled detection of vascular changes, increased the signal-to-noise ratio, and increased the sensitivity of detection of changes in perfusion in the microcirculation. It has relatively high sensitivity and specificity in the diagnosis of orbital space-occupying lesions and increases the accuracy of diagnosis.
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Affiliation(s)
- L Yan
- Department of Ultrasonography, Xijing Hospital, The Fourth Military Medical University, No. 17 West Changle Road, Xi'an 710032, China; Department of Ultrasonography, Xi'an Central Hospital, The Third Affiliated Hospital of JiaoTong University, No. 185 Houzai Gate, Xi'an 710003, China
| | - G He
- Department of Ultrasonography, Xijing Hospital, The Fourth Military Medical University, No. 17 West Changle Road, Xi'an 710032, China
| | - X Zhou
- Department of Ultrasonography, Xijing Hospital, The Fourth Military Medical University, No. 17 West Changle Road, Xi'an 710032, China.
| | - Y Zheng
- Department of Ultrasonography, Xi'an Central Hospital, The Third Affiliated Hospital of JiaoTong University, No. 185 Houzai Gate, Xi'an 710003, China
| | - Y Zhu
- Department of Ultrasonography, Xi'an Central Hospital, The Third Affiliated Hospital of JiaoTong University, No. 185 Houzai Gate, Xi'an 710003, China
| | - J Yang
- Department of CT & MRI, Xi'an Central Hospital, The Third Affiliated Hospital of JiaoTong University, No. 185 Houzai Gate, Xi'an 710003, China
| | - M Zhang
- Department of Ultrasonography, Xijing Hospital, The Fourth Military Medical University, No. 17 West Changle Road, Xi'an 710032, China
| | - Y Zhou
- Department of Ultrasonography, Xi'an Central Hospital, The Third Affiliated Hospital of JiaoTong University, No. 185 Houzai Gate, Xi'an 710003, China
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Abstract
Uveal melanoma is the most common primary intraocular malignancy in adults. It is associated with a high rate of distant tumor spread and consequent mortality. Unlike retinoblastoma, for which treatment advances over the last few decades have resulted in a dramatic improvement in survival, outcomes for patients with uveal melanoma remain unchanged. Despite improvement in local control of this tumor, roughly 50% of patients develop metastatic disease within 15 years. Delays in diagnosis and marked vascularity of this tumor may underlie that situation. Tumor size, location, histopathologic appearance, cytogenetic abnormalities, and molecular profiling are used in prognostication. The revised 7th edition of the American Joint Committee on Cancer (AJCC) manual has presented new information that may improve that process as well. Herein, we review current knowledge on uveal melanoma.
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Affiliation(s)
- Seema Kashyap
- Department of Ocular Pathology, Dr R. P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
| | - Rachna Meel
- Department of Ophthalmology, Dr R. P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Lata Singh
- Department of Ocular Pathology, Dr R. P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Mithalesh Singh
- Department of Ocular Pathology, Dr R. P. Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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