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Pratima Kathil, Paul T. Finger, Tatyana Milman; Characteristics of Anterior Uveal Melanocytomas in 18 Cases. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3263.
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To evaluate a case series of anterior uveal melanocytomas for their distinct clinical, histopathologic and high frequency ultrasound (UBM) characteristics.
Retrospective, single-center study of 18 patients, diagnosed between November 1998 and June 2010. Data was obtained through chart review. Main outcome measures included patient, tumor, high frequency ultrasound, histopathologic and follow-up characteristics. Follow-up data included change in visual acuity, growth, secondary glaucoma, extrascleral extension or malignant transformation.
Median follow-up was 21 months (range: 01-130). Mean patient age at presentation was 51 years (median: 54.5, range: 11-84 years). Tumor was darkly pigmented with nodular configuration in 94%, irregular surface in 78%, characteristic cobblestone surface appearance in 56% and feathery or fimbriated margins in 83%. Intrinsic vascularity, ectropion uveae, episcleral sentinel vessel, sector cataract, or heterochromia were not seen. UBM showed high (67%) or moderately high (17%) internal reflectivity in the majority of tumors. Thirteen involved the iris (72%), 44% were club-shaped and 100% showed no intrinsic vascularity. Mean tumor thickness was 1mm (SD±0.5, median: 0.9, range: 0.3 to 2.1). Mean largest basal dimension was 3.1mm (SD±2.3, median: 2.3, range: 0.5-9.4) (n=14). Four patients underwent tumor biopsy. Pathologic and immunohistochemical evaluation confirmed the diagnosis of melanocytoma. Correlation between UBM and histopathology was demonstrated. Three tumors (17%) had extrascleral extension, 2(11%) were documented to grow and one (6%) caused medically-controlled glaucoma.
Anterior uveal melanocytomas are uncommon, typically benign melanocytic tumors with characteristic clinical features. High frequency ultrasound imaging provides excellent views of obscure posterior extent, allows precise tumor measurement and monitoring for growth. It is an invaluable adjunct to digital slit lamp photography for evaluating tumor stability or growth. This study presents and correlates unique clinical, high frequency ultrasound and histopathologic characteristics.
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