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M. M. Pagliara, M. A. Blasi, C. G. Caputo, M. G. Sammarco, G. Savino, E. Balestrazzi; Correlation Between Clinical, Ultrasound Features and Pathologic Findings for the Diagnosis of Ciliary Body and Iris Tumors. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5152.
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to correlate clinical and high-frequency ultrasound biomicroscopic (UBM) findings of iris and ciliary body tumors with histopathologic features.
twenty patients were included in the study. All patients underwent a complete ophthalmic examination including a slit lamp biomicroscopy, gonioscopy, fundoscopy, and photography. High-frequency ultrasound biomicroscopy (UBM) was carried out using a 35 MHz commercially available device (Optikon, 2000). Trans-scleral resection (TSR) appeared to be the proper treatment choice, depending on the tumor size and location, and was performed in all patients. Histological examinations allowed definitive diagnosis.
twenty eyes from twenty patients ( 5 male, 15 female ) were included (mean age 55 years). Clinically evaluated tumors consisted of 3 iris, 14 ciliary body and 3 cilio-choroidal lesions. Clinical data were as follow: darkly pigmented ( 84.2%), lightly pigmented (10.5%), amelanotic (5.2%); nodular (52.6%), flat (47.3%); anterior chamber angle infiltration (85%), extrascleral extension (10%) and sentinel vessels (15%). Ultrasound features were nodular masses with medium internal reflectivity in all eyes (100%), homogeneous structure in 11 eyes (55%), non homogeneous structure with microcysts in 8 eyes (40%) and macrocysts in one eye (5%). Based on clinical and ultrasound findings, the working diagnosis was melanoma in all cases with the exception of the iris amelanotic mass. Histopathological examination detected 3 nevi (15%), 12 melanomas (60%), 4 melanocytomas (20%), and 1 metastasis from breast cancer (5%).
our study reveal that high-frequency UBM features and clinical data do not correlate with the histological findings in all cases. The only clinical parameters able to direct diagnosis towards malignancy are sentinel vessels and extrascleral extension. Definitive diagnosis is only reached by histopathologic examination.
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