Abstract
Purpose: :
There is increasing need to obtain fresh tumor tissue and normal tissue for genetic studies and research following enucleation of an eye for uveal melanoma, retinoblastoma and other lesions. Incorrect opening of enucleated eyes can lead to severe distortion of the globe and difficulty in histopathologic interpretation. The authors describe their technique of harvesting fresh tissue that they have developed by performing this procedure on more than 500 cases over a 30-year period.
Methods: :
Examination of a large clinical drawing and/or transillumination are then performed and the tumor margins are outlined with marking pencil immediately after enucleation. Prior to opening the globe, a proximal segment of optic nerve is sectioned and placed separately in formaldehyde. An 8 mm corneal trephine is used to open the sclera at a site that straddles the tumor margin with 1/3 of the trephine over the tumor and 2/3 over the adjacent normal sclera. Fresh tumor tissue is obtained at that site with scissors or curette and submitted for genetic studies or research projects. The ophthalmic pathologist can then section the globe so that the trephine opening is in the calotte and the remaining tumor is in the pupillary-optic nerve section, allowing excellent histopathologic slides.
Results: :
Using this technique, artifactual tumor seeding in the optic nerve is avoided and very satisfactory histopathologic slides are obtained. On more than 500 procedures there have been no serious problems related to insufficient yield and histopathologic interpretations.
Keywords: tumors • pathology techniques • melanoma