Purchase this article with an account.
R.B. Avery, D.M. Albert, W.R. Green, H.E. Grossniklaus, M. Diener-West; Histopathologic Characterization of Eyes Enucleated following Brachytherapy in the Collaborative Ocular Melanoma Study (COMS) . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1555.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose: To describe the histopathologic findings in eyes with uveal melanoma that were enucleated following brachytherapy. Eyes had been randomized to the I-125 plaque treatment in the COMS medium-sized tumor study. Methods: Following enucleation within the COMS protocol, eyes were examined independently by three ophthalmic pathologists. Findings were recorded on a standardized data form. A composite of findings was obtained after adjudication. Results: Seventy-eight eyes were available for analysis. In 44 eyes (56%), the lesion was entirely posterior to the equator. The iris was involved in 3(4%) and 11(14%) eyes had ciliary body involvement. The cell-types were classified as epithelioid (9%), spindle (5%), mixed (82%), or other (4%). In a count of 40 high-power fields, no mitotic figures could be identified in 37% of the tumors. Of the 49 tumors with mitotic figures, the mean number counted was 1.4 (range 1-16 per 40 hpf). Inflammation was graded as none-to-minimal (32%), moderate (56%), or marked (12%). The degree of necrosis was categorized as none (23%), 1-50% (60%), or >50% (17%). Pigmentation was graded as minimal (44%), moderate (32%), or heavy (24%). Vascular lakes were seen in 81% of eyes and tumor vessels were prominent in 73%. The retina was invaded in 68% and retinal detachment was seen in 91%. Rubeosis was present in 37% and tumor cells were seen in the vitreous in 36%. Conclusions: Eyes undergoing secondary enucleation after plaque brachytherapy have specific histopathologic characteristics. These may represent factors associated with plaque failure or changes following brachytherapy.
This PDF is available to Subscribers Only