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Păsărică MA, Curcă PF, Dragosloveanu CDM, Tătaru CI, Manole IR, Murgoi GE, Grigorescu AC. Underlying Ciliary Body Uveal Melanoma in a Patient with Chronic Lymphocytic Leukemia Presenting for Hyphema. Diagnostics (Basel) 2022; 12:diagnostics12061312. [PMID: 35741122 PMCID: PMC9221604 DOI: 10.3390/diagnostics12061312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/16/2022] [Accepted: 05/24/2022] [Indexed: 11/29/2022] Open
Abstract
(1) Background: Ciliary body uveal melanoma is a rare subtype of uveal melanoma which comprises 3–5% of melanomas, an immunogenic cancer, and can present multifaceted initial clinical manifestations, masquerading as various ocular pathologies. Chronic lymphocytic leukemia (CLL) presents immunodeficiency and risk for the development of a secondary malignancy, with Bruton’s tyrosine kinase inhibitor treatment having a mutagenic effect and a secondary anti-platelet aggregation effect. We present the case of a 65-year-old patient undergoing treatment for CLL with ibrutinib who presented with recurrent hyphema that masked an underlying, inferiorly situated, ciliary body uveal melanoma; (2) Methods: Retrospective case review; (3) Results: An ophthalmological examination together with imaging via mode B ultrasound and contrast-enhanced magnetic resonance imaging resulted in the clinical and imagistic diagnosis of a ciliary body uveal melanoma. A pathological examination of the enucleated eye confirmed the diagnosis. Postoperative tumoral reoccurrence was not detected for 1½ years, however, CLL immunosuppression worsened with admission for severe COVID-19 disease. (4) Conclusions: CLL patient screening for melanoma should also include detailed ophthalmological examinations, which could also include ultrasound ophthalmological imaging. The avoidance of uveal melanoma metastatic disease is paramount for patient survival. CLL manifests additional profound immunosuppression.
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Affiliation(s)
- Mihai Adrian Păsărică
- Clinical Department of Ophthalmology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.A.P.); (C.D.M.D.); (C.I.T.); (A.C.G.)
- Department of Ophthalmology, Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania;
| | - Paul Filip Curcă
- Clinical Department of Ophthalmology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.A.P.); (C.D.M.D.); (C.I.T.); (A.C.G.)
- Department of Ophthalmology, Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania;
- Correspondence: ; Tel.: +40-72-015-4452
| | - Christiana Diana Maria Dragosloveanu
- Clinical Department of Ophthalmology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.A.P.); (C.D.M.D.); (C.I.T.); (A.C.G.)
- Department of Ophthalmology, Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania;
| | - Cătălina Ioana Tătaru
- Clinical Department of Ophthalmology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.A.P.); (C.D.M.D.); (C.I.T.); (A.C.G.)
- Department of Ophthalmology, Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania;
| | - Ioana Roxana Manole
- Department of Ophthalmology, Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania;
| | - Gabriela Elisabeta Murgoi
- Department of Oncology, Institute of Oncology Prof. Dr. Alexandru Trestioreanu, 022328 Bucharest, Romania;
| | - Alexandru Călin Grigorescu
- Clinical Department of Ophthalmology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.A.P.); (C.D.M.D.); (C.I.T.); (A.C.G.)
- Department of Oncology, Clinical Hospital of Nephrology Dr. Carol Davila, 010731 Bucharest, Romania
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