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Boukari M, Braham IZ, Kaouel H, Anane M, Ammous I, Zhioua R. Bilateral diffuse uveal melanocytic proliferation: Report of a rare Ocular Paraneoplastic Syndrome. LA TUNISIE MEDICALE 2021; 99:298-301. [PMID: 33899202 PMCID: PMC8715793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/30/2022]
Abstract
Bilateral diffuse uveal melanocytic proliferation is a rare paraneoplastic disorder where bilateral blindness is caused by uveal thickening, serous retinal detachment, and rapid cataract formation. Several different malignancies have been associated with bilateral diffuse uveal melanocytic proliferation, but ovarian carcinoma in women and lung and pancreatic carcinoma in men are the most common. The underlying mechanism is thought to be related to a an endogenous factor wich regulates the proliferation of uveal melanocytes. We present the case of a 75-year-old man with bilateral diffuse uveal melanocytic proliferation secondary to pulmonary adenocarcinoma.
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Iannetti L, Corsi C, Iafrate F, Sammartino P, Di Giorgio A, Pezzi PP. Bilateral Uveitis with Hypopyon as a Presenting Symptom of Metastatic Peritoneal Carcinomatosis. Eur J Ophthalmol 2018; 20:948-51. [DOI: 10.1177/112067211002000522] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Ludovico Iannetti
- Department of Ophthalmology, “La Sapienza” University of Roma, Roma - Italy
| | - Cinzia Corsi
- Department of Ophthalmology, “La Sapienza” University of Roma, Roma - Italy
| | - Franco Iafrate
- Department of Radiological Sciences, “La Sapienza” University of Roma, Roma - Italy
| | - Paolo Sammartino
- Department of Surgery “Pietro Valdoni”, “La Sapienza” University of Roma, Roma - Italy
| | - Angelo Di Giorgio
- Department of Surgery “Pietro Valdoni”, “La Sapienza” University of Roma, Roma - Italy
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Şatırtav G, Donbaloğlu M, Oltulu R, Oltulu P, Kerimoğlu H, Özkağnıcı A. Unilateral Recurrent Anterior Uveitis as the Presenting Sign of Bladder Carcinoma. Turk J Ophthalmol 2016; 46:190-193. [PMID: 28058157 PMCID: PMC5200827 DOI: 10.4274/tjo.92259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 10/24/2014] [Indexed: 12/01/2022] Open
Abstract
A 79-year-old male patient was followed for unilateral uveitis with 3 attacks in 10 months, despite initial improvement with steroid therapy. The patient had visual acuity (VA) of counting fingers in right eye, hypopyon and vitritis with no chorioretinal lesions. The left eye was normal. The patient was evaluated for intraocular foreign body, intraocular lymphoma and associated systemic disease and malignancy. Computed tomography of the abdomen showed a mass in the bladder. Biopsy confirmed bladder carcinoma. After resection of the mass, intraocular inflammation improved completely and no attack was noted in the follow-up. In his last examination, two years after the operation, VA was light perception; seclusio pupilla and mature cataracts were seen on biomicroscopy. There was no sign of vitritis on ocular ultrasonography. Evidence is discussed that suggests a link and potential etiology between refractory uveitis with hypopyon and bladder carcinoma. This is the first case of unilateral recurrent uveitis with hypopyon as the initial presenting sign of bladder carcinoma.
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Affiliation(s)
- Günhal Şatırtav
- Necmettin Erbakan University Meram Faculty of Medicine, Department of Ophthalmology, Konya, Turkey
| | - Meryem Donbaloğlu
- Necmettin Erbakan University Meram Faculty of Medicine, Department of Ophthalmology, Konya, Turkey
| | - Refik Oltulu
- Necmettin Erbakan University Meram Faculty of Medicine, Department of Ophthalmology, Konya, Turkey
| | - Pembe Oltulu
- Necmettin Erbakan University Meram Faculty of Medicine, Department of Pathology, Konya, Turkey
| | - Hürkan Kerimoğlu
- Necmettin Erbakan University Meram Faculty of Medicine, Department of Ophthalmology, Konya, Turkey
| | - Ahmet Özkağnıcı
- Necmettin Erbakan University Meram Faculty of Medicine, Department of Ophthalmology, Konya, Turkey
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Abstract
BACKGROUND Paraneoplastic syndromes that affect the visual pathways and present with neuro-ophthalmologic signs or symptoms may involve the afferent or efferent systems. Afferent syndromes may involve the optic nerve or retina and, in some cases, these may be associated with systemic neurologic disease. Efferent symptoms typically affect eye movements and may involve the neuromuscular junction or involuntary eye movements. EVIDENCE ACQUISITION Literature review and personal clinical and research experience. RESULTS Diagnosis of paraneoplastic syndromes relies on clinical and laboratory evaluations. In the appropriate clinical setting, the presence of specific antibodies may help confirm the diagnosis. CONCLUSIONS In some cases, the visual pathway disturbance precedes a diagnosis of malignancy. Astute observation and selective evaluation and management are critical to establish the correct diagnosis and institute therapeutic approaches that can be sight or life saving.
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Keppi JJ, Perdomo-Trujillo Y, Speeg-Schatz C, Sauer A. [Melanoma associated retinopathy: A case report]. J Fr Ophtalmol 2016; 39:e97-9. [PMID: 26947326 DOI: 10.1016/j.jfo.2014.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 12/02/2014] [Accepted: 12/11/2014] [Indexed: 11/19/2022]
Affiliation(s)
- J-J Keppi
- Service d'ophtalmologie, centre hospitalier universitaire de Strasbourg, nouvel hôpital civil, BP 426, 67091 Strasbourg, France
| | - Y Perdomo-Trujillo
- Centre de référence des affections ophtalmologiques d'origine génétique, centre hospitalier universitaire de Strasbourg, 67091 Strasbourg, France
| | - C Speeg-Schatz
- Service d'ophtalmologie, centre hospitalier universitaire de Strasbourg, nouvel hôpital civil, BP 426, 67091 Strasbourg, France
| | - A Sauer
- Service d'ophtalmologie, centre hospitalier universitaire de Strasbourg, nouvel hôpital civil, BP 426, 67091 Strasbourg, France.
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Abstract
PURPOSE Systemic neoplastic processes can affect the retina through autoimmune retinopathy. This process may present in a variety of patterns. A novel pattern of paraneoplastic autoimmune retinopathy has been described. METHODS Two patients presented with paraneoplastic vision changes. Optical coherence tomography and multifocal electroretinography were performed, which showed a unique focal retinal change in both patients. Case 1 is a 20-year-old woman with history of cutaneous melanoma. Case 2 is 67-year-old woman with history of breast cancer. RESULTS Both patients showed a localized area of foveal thinning that corresponded with areas of depression on multifocal electroretinography. Each tested positive for antiretinal antibodies. CONCLUSION This is a novel manifestation of paraneoplastic autoimmune retinopathy. Previously described cases have all affected the retina diffusely. These cases highlight the need to consider distant neoplastic processes when evaluating patient with similar presentations to those depicted here.
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Oray M, Kir N, Tuncer S, Onal S, Tugal-Tutkun I. Autoimmune retinopathies: a report of 3 cases. Ocul Immunol Inflamm 2013; 21:424-33. [PMID: 23730997 DOI: 10.3109/09273948.2013.799215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To describe 3 representative cases of autoimmune retinopathy (AIR). METHODS Clinical records of patients with a diagnosis of AIR were analyzed for demographic data, clinical findings, ancillary and laboratory tests, and treatment employed. RESULTS Three female patients diagnosed with AIR had bilateral reduction of electroretinogram amplitudes and elevation of visual field threshold within the central 30 degrees of the visual field that was disproportionately more severe than the clinical findings of retinal degeneration. The diagnoses were cancer-associated retinopathy, non-neoplastic AIR, and hereditary retinal dystrophy with secondary inflammation. Optic nerve involvement was also present in all cases. The patient with non-neoplastic AIR was successfully treated with systemic corticosteroids and immunomodulatory agents. CONCLUSION High index of suspicion is essential for an early diagnosis of AIR. Visual function and electrophysiological tests should be included in the initial workup of patients who present with suggestive clinical signs and symptoms of AIR.
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Affiliation(s)
- Merih Oray
- Department of Ophthalmology, Mus Public Hospital , Mus , Turkey
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Adamus G, Choi D, Raghunath A, Schiffman J. Significance of Anti-retinal Autoantibodies in Cancer-associated Retinopathy with Gynecological Cancers. ACTA ACUST UNITED AC 2013; 4:307. [PMID: 24672741 PMCID: PMC3963281 DOI: 10.4172/2155-9570.1000307] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND The presence of autoantibodies (AAbs) is the primary serological indicator of autoimmunity. Cancer-associated retinopathy (CAR) is associated with AAbs and different types of cancer. The goal of the study was to examine the profile of serum autoantibodies in women with gynecological cancers with and without paraneoplastic visual manifestation. METHODS Retrospective studies of a cohort of 46 women with symptoms of CAR and gynecological tumors, including endometrial, cervical, ovarian, and fallopian tubes, 111 women with similar tumors without symptoms of CAR, and 60 age-matched healthy controls. Presence of serum AAbs and the identity of targeted antigens were performed by western blotting and their significance was evaluated using an Fisher's exact test. RESULTS The patients with gynecological CAR had the highest proportion of seropositivity (80%), followed by patients with gynecological cancers without CAR (61%) and healthy controls (58%). Differences in recognition frequencies were found for 17 antigens and 5 retinal antigens were frequently targeted: enolase, aldolase C, carbonic anhydrase II, recoverin and GAPDH. The occurrence of anti-glycolytic enzymes was 2-3 times more frequent in CAR and cancer patients than healthy controls. Anti-recoverin AAbs were prevalent in endometrial CAR. Anti-CAII antibodies were not significantly different between groups of women. In this cohort, cancer was diagnosed before the onset of retinopathy with latency from 2 months to 30 years. The discovery of the ovarian and endometrial cancers and manifestation of visual problems often coincided but Fallopian tube carcinoma was found after visual onset. CONCLUSION New retinal targets were identified for gynecological CAR. Each gynecological-CAR has its own autoantibody profile different from non-CAR profile, implying that a complex autoantibody signature may be more predictable for diagnosis than a singular AAb. Specific anti-retinal AAbs were most prevalent in women with CAR but their profiles were not fully distinguished from cancer controls.
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Affiliation(s)
- Grazyna Adamus
- Ocular Immunology Laboratory, Casey Eye Institute, School of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Dongseak Choi
- Department Public Health and Preventive Medicine, Department School of Medicine, Oregon Health & Science University, Portland, OR 97239, USA
| | - Anitha Raghunath
- Department of Ophthalmology and Neuro-oncology, University of Texas, MD Anderson Cancer Center, Houston, Texas 77030, USA
| | - Jade Schiffman
- Department of Ophthalmology and Neuro-oncology, University of Texas, MD Anderson Cancer Center, Houston, Texas 77030, USA
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Lima LH, Greenberg JP, Greenstein VC, Smith RT, Sallum JMF, Thirkill C, Yannuzzi LA, Tsang SH. Hyperautofluorescent ring in autoimmune retinopathy. Retina 2012; 32:1385-94. [PMID: 22218149 PMCID: PMC4377132 DOI: 10.1097/iae.0b013e3182398107] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
PURPOSE To report the presence of a hyperautofluorescent ring and corresponding spectral-domain optical coherence tomography (SD-OCT) features seen in patients with autoimmune retinopathy. METHODS All eyes were evaluated by funduscopic examination, full-field electroretinography, fundus autofluorescence, and SD-OCT. Further confirmation of the diagnosis was obtained with immunoblot and immunohistochemistry testing of the patient's serum. Humphrey visual fields and microperimetry were also performed. RESULTS Funduscopic examination showed atrophic retinal pigment epithelium (RPE) associated with retinal artery narrowing but without pigment deposits. The scotopic and photopic full-field electroretinograms were nondetectable in three patients and showed a cone-rod pattern of dysfunction in one patient. Fundus autofluorescence revealed a hyperautofluorescent ring in the parafoveal region, and the corresponding SD-OCT demonstrated loss of the photoreceptor inner segment-outer segment junction with thinning of the outer nuclear layer from the region of the hyperautofluorescent ring toward the retinal periphery. The retinal layers were generally intact within the hyperautofluorescent ring, although the inner segment-outer segment junction was disrupted, and the outer nuclear layer and photoreceptor outer segment layer were thinned. CONCLUSION This case series revealed the structure of the hyperautofluorescent ring in autoimmune retinopathy using SD-OCT. Fundus autofluorescence and SD-OCT may aid in the diagnosis of autoimmune retinopathy and may serve as a tool to monitor its progression.
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Affiliation(s)
- Luiz H Lima
- Vitreous, Retina, Macula Consultants of New York and The LuEsther T. Mertz Retinal Research Center, Manhattan Eye, Ear, and Throat Hospital, New York, New York, USA
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Clear cell carcinoma of the endometrium causing paraneoplastic retinopathy: case report and review of the literature. Case Rep Obstet Gynecol 2011; 2011:631929. [PMID: 22567514 PMCID: PMC3335617 DOI: 10.1155/2011/631929] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2011] [Accepted: 06/21/2011] [Indexed: 11/18/2022] Open
Abstract
We reviewed the literature for cases in which gynecologic malignancies caused paraneoplastic retinopathy and ultimately led to blindness. Twenty-eight cases were derived from the literature, and one unique case is described from our institution. Of these 28 cases, 14 patients were diagnosed with endometrial cancer, 7 with ovarian cancer, 5 with cervical cancer, 1 fallopian tube cancer and 1 with concomitant endometrial and ovarian cancers. The average age of patients at the time of diagnosis was 64 years (range, 35-89 years). Typically, ocular manifestations antedate symptoms of the underlying carcinoma by 3-12 months. Information regarding the interval from visual symptoms to time of death is limited, but ranges from several months to several years. Our report is the first to document a clear cell carcinoma of the endometrium causing paraneoplastic retinopathy and is the first to review all gynecologic malignancies associated with visual paraneoplastic syndromes.
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Koike C, Numata T, Ueda H, Mori Y, Furukawa T. TRPM1: a vertebrate TRP channel responsible for retinal ON bipolar function. Cell Calcium 2010; 48:95-101. [PMID: 20846719 DOI: 10.1016/j.ceca.2010.08.004] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2010] [Revised: 08/12/2010] [Accepted: 08/12/2010] [Indexed: 12/22/2022]
Abstract
The transient receptor potential (TRP) channels affect essential functions widely in sensory systems of various species, both invertebrates and vertebrates. The channel protein encoded by the trp gene, the first identified TRP superfamily molecule, is known to mediate the Drosophila light response. A vertebrate TRP channel playing a crucial role in the visual system has not yet been discovered, although numerous studies have revealed primal functions of TRP superfamily molecules in various sensory systems other than vision. In the retina, which is the entry tissue in the vertebrate visual pathway, the transduction cation channel in ON bipolar cells has been elusive, despite intensive investigation by many researchers over a long period of time. Recent studies finally revealed that TRPM1, the first member of the melanoma-related transient receptor potential (TRPM) subfamily to be discovered, is a visual transduction channel in retinal ON bipolar cells. This review covers the significant discoveries on the physiological function and regulatory mechanism of the TRPM1 channel in retinal ON bipolar cells and the association of human TRPM1 mutations with congenital stationary night blindness.
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Affiliation(s)
- Chieko Koike
- Department of Developmental Biology, Osaka Bioscience Institute, Furuedai, Suita, Japan
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Gorin M. Secondary Photoreceptor Degenerations*. ENCYCLOPEDIA OF THE EYE 2010. [PMCID: PMC7148624 DOI: 10.1016/b978-0-12-374203-2.00212-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
The means whereby vision can be lost from a disease located distant from the eye include autoimmunity, with sensitization resulting from extraocular stimuli, a process illustrated here by the immunologic confusion caused by cancers. The uncontrolled proliferation of malignancies commonly involves the expression of components of the central nervous system, but a damaging loss of tolerance is rare. When autoimmunity does develop, organ-specific antigens are more often involved than the more generalized and widely disseminated common neuronal components. A focus upon a single antigen is typical of the immune-mediated paraneoplasia, a collection of syndromes identified by unusual antibody reactions. This review provides an outline of the immunologic trail that led to the recognition of autoimmunity in paraneoplastic ocular degenerations, how specific antibody reactions aid in diagnosis, and the possibility of including antibodies in modes for sight-saving intervention. 'Those who do not know history are destined to repeat it'.
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Affiliation(s)
- Charles E Thirkill
- CAR Reference Laboratory, Research One, U.C. Davis Medical Center, Sacramento, CA 95817, USA.
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Audo I, Robson AG, Holder GE, Moore AT. The negative ERG: clinical phenotypes and disease mechanisms of inner retinal dysfunction. Surv Ophthalmol 2008; 53:16-40. [PMID: 18191655 DOI: 10.1016/j.survophthal.2007.10.010] [Citation(s) in RCA: 109] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Inner retinal dysfunction is encountered in a number of retinal disorders, either inherited or acquired, as a primary or predominant defect. Fundus examination is rarely diagnostic in these disorders, although some show characteristic features, and careful electrophysiological assessment of retinal function is needed for accurate diagnosis. The ERG in inner retinal dysfunction typically shows a negative waveform with a preserved a-wave and a selectively reduced b-wave. Advances in retinal physiology and molecular genetics have led to a greater understanding of the pathogenesis of these disorders. This review summarizes current knowledge on normal retinal physiology, the investigative techniques used and the range of clinical disorders in which there is predominantly inner retinal dysfunction.
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Kobayashi M, Ikezoe T, Uemura Y, Ueno H, Taguchi H. Long-term survival of a patient with small cell lung cancer associated with cancer-associated retinopathy. Lung Cancer 2007; 57:399-403. [PMID: 17397962 DOI: 10.1016/j.lungcan.2007.02.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2006] [Revised: 02/10/2007] [Accepted: 02/15/2007] [Indexed: 10/23/2022]
Abstract
Cancer-associated retinopathy (CAR) is a rare paraneoplastic disorder that is frequently found in patients with small cell lung cancer (SCLC); it is caused by autoantibody to the 23-kDa photoreceptor protein, recoverin. We report a 9-year survivor of SCLC after concurrent chemoradiotherapy. His anti-recoverin antibody remains positive. Long-term survival without SCLC recurrence might be related to an autoimmunity mechanism that causes CAR due to the presence of anti-recoverin antibody cross-reacting with retinal cells and tumor cells. The current literature review was conducted to evaluate the impact on overall survival according to anti-recoverin antibody status.
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Affiliation(s)
- Makoto Kobayashi
- Department of Hematology and Respiratory Medicine, Kochi Medical School, Kochi University, Nankoku, Kochi 783-8505, Japan.
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Goetgebuer G, Kestelyn-Stevens AM, De Laey JJ, Kestelyn P, Leroy BP. Cancer-associated retinopathy (CAR) with electronegative ERG: a case report. Doc Ophthalmol 2007; 116:49-55. [PMID: 17721792 DOI: 10.1007/s10633-007-9074-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2007] [Revised: 06/25/2007] [Accepted: 07/12/2007] [Indexed: 11/29/2022]
Abstract
Cancer-associated retinopathy (CAR) should be suspected in patients who present with visual symptoms such as rapid unexplained visual loss and seeing shimmering lights, with an abnormal ERG. Electronegative ERG responses are not exclusive to melanoma-associated retinopathy (MAR) but may be seen in CAR as well. We describe a patient with CAR who presented with an electronegative ERG. A 67-year old woman, who presented with complaints of seeing shimmering lights, underwent an extensive ophthalmological and electrophysiological examination. Best-corrected visual acuity was 7/10 in the right and 9/10 in the left eye. Goldmann visual fields showed relative central scotomata and concentric narrowing. Slit-lamp and fundus examination were normal as was fluorescein angiography. Rod-specific ERG responses were severely reduced, with electronegative maximal combined rod-cone responses and delayed cone-responses with normal amplitudes. Melanoma-associated retinopathy was suspected. Extensive dermatological and internal evaluation eventually revealed an oat-cell carcinoma in the right lung. The patient died of pneumonia 2 years after presentation.
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Affiliation(s)
- Griet Goetgebuer
- Department of Ophthalmology, Ghent University Hospital, De Pintelaan 185, Ghent 9000, Belgium
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Kobayashi M, Ikezoe T, Uemura Y, Takeuchi T, Ueno H, Ohtsuki Y, Taguchi H. Establishment of a novel small cell lung carcinoma cell line with specific recoverin expression from a patient with cancer-associated retinopathy. Lung Cancer 2007; 56:319-26. [PMID: 17374419 DOI: 10.1016/j.lungcan.2007.01.030] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2006] [Revised: 12/03/2006] [Accepted: 01/25/2007] [Indexed: 11/26/2022]
Abstract
We analysed the biologic properties of a small cell lung carcinoma cell line (designated KK0206) established from a patient with SCLC who had cancer-associated retinopathy (CAR). Morphological and immunohistochemical studies showed that KK0206 cells have features of the classic type of SCLC. KK0206 cells grew in suspension, forming relatively small clumps of cells with a doubling time of 72 h. On light microscopy, the cells were relatively small with little cytoplasm. On immunohistochemistry using anti-bovine recoverin rabbit antibody, the cells were intensely positive for recoverin. In addition, they were positive for NSE, Ki-67, and TP53. They also expressed human recoverin, a photoreceptor protein, whose presence was confirmed by RT-PCR analysis with cDNA sequencing and Western blot analysis. The point mutation of their TP53 gene (exon 156) was detected as well. The present study demonstrates that human recoverin is expressed in SCLC cells cultured from an anti-recoverin antibody-negative patient with CAR. KK0206 might be important for further research on SCLC related retinopathy.
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Affiliation(s)
- Makoto Kobayashi
- Department of Haematology, Kochi Medical School, Kochi University, Nankoku, Kochi 783-8505, and Division of Pathology, Matsuyama-Shimin Hospital, Ehime, Japan.
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Khan N, Huang JJ, Foster CS. Cancer associated retinopathy (CAR): An autoimmune-mediated paraneoplastic syndrome. Semin Ophthalmol 2006; 21:135-41. [PMID: 16912011 DOI: 10.1080/08820530500350662] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Cancer associated retinopathy (CAR) is an uncommon paraneoplastic retinopathy in which antibodies are directed against retinal antigens. Vision loss is associated with abnormal ERG findings. Few case reports and lack of controlled clinical trials make management of this syndrome especially challenging for the clinician. Herein, we describe the clinical, histopathologic and electrophysiologic features of CAR, along with a summary of previously employed management options. Cancer associated retinopathy syndrome has been recognized as a paraneoplastic disorder, most commonly associated with small cell lung cancer, in which cross-reacting autoantibodies against retinal antigen cause retinal dysfunction. Bilateral vision loss as a result of both rod and cone dysfunction in CAR may occur over a period of months, and visual symptoms may precede diagnosis of the systemic malignancy. The heterogeneity in antigens that have been identified as targets of antibody-mediated retinal damage perhaps help to explain the complexity of symptoms and the treatment challenges posed by patients with CAR.
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Affiliation(s)
- Nadia Khan
- Massachusetts Eye Research & Surgery Institute & Ocular Immunology & Uveitis Foundation, Harvard Medical School, Cambridge, MA 02142, USA
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Koch M, Langmann A, Langmann G. Konversionssyndrom bei Aderhautmelanom. SPEKTRUM DER AUGENHEILKUNDE 2006. [DOI: 10.1007/bf03163802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Wolsey DH, Warner JEA. Small Cell Lung Carcinoma Presenting as Collapsin Response-Mediating Protein (CRMP) -5 Paraneoplastic Optic Neuropathy. J Neuroophthalmol 2006; 26:187-9. [PMID: 16966937 DOI: 10.1097/01.wno.0000235578.80051.0e] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A 77-year-old woman presenting with progressive visual loss in both eyes was found to have small cell lung cancer. Assay for collapsin response-mediating protein (CRMP) -5 was positive suggesting a paraneoplastic optic neuropathy (PON). During treatment of the small cell lung cancer, the patient died of pneumonia and autopsy disclosed neuropathologic abnormalities consistent with PON. This is only the second case of CRMP-5-confirmed PON to report neuropathologic findings.
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Affiliation(s)
- Darcy H Wolsey
- Moran Eye Center, University of Utah, Salt Lake City, Utah, USA.
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Abstract
The paraneoplastic neurologic disorders (PND) are a diverse group of diseases characterized by the presence of neurologic dysfunction in the setting of a remote cancer. PND can affect almost any part of the nervous system, and are most commonly associated with lung cancer (small cell) and gynecologic tumors. Laboratory studies have demonstrated that an autoimmune response links the neurologic disorder and the cancer, and established a model whereby the cancer is believed to initiate the syndrome by expressing a protein antigen normally expressed in the nervous system, leading to anti-tumor immune response followed by autoimmune neurologic symptoms. We review the currently known PND and their pathogenesis.
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Affiliation(s)
- Robert B Darnell
- Howard Hughes Medical Institute and Laboratory of Molecular Neuro-Oncology, The Rockefeller University, New York, NY 10021, USA.
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Verhulst D, Demaerel P, Damato B, Leys A. Bilateral ocular metastasis from an occult primary melanoma. Br J Ophthalmol 2006; 90:922-3. [PMID: 16782957 PMCID: PMC1857158 DOI: 10.1136/bjo.2006.092445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Merbs SL, Green WR. Pathology of Choroidal Melanoma. Retina 2006. [DOI: 10.1016/b978-0-323-02598-0.50041-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Ju W, Park IA, Kim SH, Lee SE, Kim SC. Small cell carcinoma of the uterine corpus manifesting with visual dysfunction. Gynecol Oncol 2005; 99:504-6. [PMID: 16112716 DOI: 10.1016/j.ygyno.2005.06.045] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2005] [Revised: 06/08/2005] [Accepted: 06/14/2005] [Indexed: 11/30/2022]
Abstract
BACKGROUND Small cell carcinoma in the uterine corpus rather than the endometrium has not been reported yet which resembles a uterine leiomyosarcoma on an imaging study. Furthermore, gynecologic malignancies manifested as a visual dysfunction render the early suspicion and accurate diagnosis a difficult proposition. CASE A 57-year-old Korean woman was referred to the Department of Obstetrics and Gynecology due to incidentally detected uterine mass. She had been suffering from a visual loss for several weeks. This uterine mass mimicking a leiomyosarcoma on pelvis MRI was identified to be a small cell carcinoma via a transvaginal gun biopsy and consequent immunostaining. The patient was then scheduled to undergo a regimen of chemotherapy with etoposide and carboplatin. CONCLUSION Small cell carcinoma may arise from the uterine corpus rather than the endometrium and may also be accompanied by visual symptoms.
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Affiliation(s)
- Woong Ju
- Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University, Yang Chun-Ku, Seoul, Republic of Korea.
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Erro Aguirre ME, Maisterra Santos O, Gallego Culieré J. Síndromes paraneoplásicos neurológicos. Med Clin (Barc) 2005; 125:543-7. [PMID: 16266639 DOI: 10.1157/13080457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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