Abstract
Purpose:
To report on the heterogeneity of monosomy 3 within a fine needle aspiration biopsy obtained transsclerally from choroidal melanoma for prognostication.
Methods:
All clinical records of patients who were diagnosed with choroidal melanoma and underwent iodine-125 plaque brachytherapy or enucleation with intraoperative transscleral fine needle aspiration biopsy from January 2005 to August 20, 2011 and who had a positive result for monosomy 3 by fluorescence in situ hybridization as reported by clinical cytogenetics testing were collected. Patient age and gender, total number of cells evaluated and number of cells positive for monosomy 3, tumor size, and metastatic outcome were recorded for each patient.
Results:
A positive result for monosomy 3 was reported in 98 patients who underwent transscleral fine needle aspiration biopsy. Two patients were lost to follow-up immediately post-operatively, and the remaining 96 patients were included in this study. The mean number of cells evaluated in the biopsy was 275 (range 28 to 520). The mean percentage of cells positive for monosomy 3 was 62.0% (range 4.7-100%). Five patients (5%) were treated by enucleation, and 91 patients (95%) underwent brachytherapy. The mean tumor height was 6.20 mm (range 1.99 to 19.42 mm). Tumor size did not correlate with percentage of monosomy 3 in the biopsy. In an average follow-up interval of 28.7 months (range 3-76 months), choroidal melanoma metastasis developed in 21 (22%) patients. There was no significant difference in the percentage of monosomy 3 in the biopsy of patients who developed metastasis (68.6%) compared to those who did not develop metastasis (60.2%) (p=0.31) during the follow-up period.
Conclusions:
Cytogenetic heterogeneity of fluorescent in-situ hybridization for monosomy 3 exists within a biopsy sample. Tumor size did not correlate with the percentage of monosomy 3 in the biopsy. Furthermore, the percentage of monosomy 3 within the biopsy did not correlate with the development of choroidal melanoma metastasis during the follow-up interval. Therefore, a positive finding of monosomy 3 within a tumor biopsy, regardless of percentage of cells positive, may portend a poor prognosis for metastasis.
Keywords: 589 melanoma •
624 oncology •
744 tumors