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Maria Pefkianaki, Archana Srinivasan, Arman Mashayekhi, Jerry A Shields, Carol L Shields; Cytogenetic evaluation of 26 patients with documented transformation of iris nevus into iris melanoma. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4420.
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To investigate the cytogenetic features of iris melanoma photographically documented to originate from presumed iris nevus.
We reviewed the clinical records of 26 consecutive patients with documented growth of presumed iris nevus into iris melanoma. All patients were managed at the Ocular Oncology Service, Wills Eye Hospital, Philadelphia USA and had undergone fine-needle aspiration biopsy (FNAB) of the iris melanoma for cytogenetic evaluation of chromosomes 1,3, 6, 8.
All patients were Caucasian and 11 (42%) were male. One patient (4%) had medical history of skin melanoma. The median patient’s age at the time of diagnosis of iris nevus was 42 years (SD: 24 years). The mean interval between diagnosis of iris nevus and transformation into iris melanoma was 80 months (SD: 54 months). The interval between diagnosis of iris nevus and transformation into iris melanoma was less than two years in 5 eyes (19%) and more than 2 years in 21 (81%) eyes.At the time of diagnosis of iris melanoma, the median tumor diameter was 4.8 mm (IQR: 2.4 mm) and the tumor thickness by ultrasonography was 2.5 mm (SD: 1.2 mm). Overall, 15 patients (58%) had high-risk cytogenetic findings predictive of potential systemic metastasis. There was no correlation between cytogenetic features and time interval of tumor transformation (p=0.36), presence of iris stromal seeds (p=0.70), and presence of angle seeds (p=0.59). There were no instances of distant metastasis during a median follow-up of 118 months (SD: 55 months).
To our knowledge, this is the first study on the cytogenetic features of a series of iris melanoma photographically documented to originate from iris nevus. Our findings documented high risk cytogenetic features in 58% patients and this did not correlate with rate of transformation or the presence of tumor seeding.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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