Abstract
Purpose: :
In most reported series of intraocular tumor biopsies, all cases are lumped together for data analysis and summarization. However, not all biopsies of intraocular tumors are performed for the same reason. Although the principal reason for intraocular tumor biopsy in most series is major diagnostic uncertainty, some are performed to convince skeptical patients or professional colleagues, to evaluate performance of specific biopsy methods, or to obtain specimens of uveal melanomas for cytogenetic or gene expression testing. The purpose of this report was to evaluate differences between cases/tumors subjected to biopsies performed for different indications.
Methods: :
Retrospective review of 702 fine-needle aspiration biopsies (FNAB) of solid intraocular tumors suspected of being malignant neoplasms (1981 - 2011). Biopsies were categorized by principal indication into the following four groups: (1) diagnostic, (2) confirmatory, (3) investigational, and (4) prognostic. Classification criteria for biopsies of these different categories will be presented in detail.
Results: :
The 702 biopsies were categorized as follows: (1) diagnostic [n = 268], (2) confirmatory [n = 71], (3) investigational [286], and (4) prognostic [n = 77]. The tumors in the different biopsy categories differed substantially in pre-biopsy clinical diagnosis, tumor size, intraocular tumor location, and relevant tumor features. The cases in the different categories were also associated with differential yields of cells, different risks and potential complications of biopsy, and different prognostic outcomes. Patient management was influenced only by the results of diagnostic and confirmatory biopsies.
Conclusions: :
The taxonomy of biopsies described in this report is useful for comparison of alternative methods of intraocular tumor biopsies. Failure to consider differences among patient groups undergoing biopsy for different reasons risks failure to recognize and adjust for differences in expected results/outcomes of alternative biopsy methods.
Keywords: tumors • pathology: human • clinical (human) or epidemiologic studies: systems/equipment/techniques