Choroidal Melanoma: Our Experience

Background: Choroidal melanomas are diagnosed in approximately 6 out of one million Americans per year, and although their incidence is low, they are the most common primary intraocular tumor in adults. Methods: Choroidal melanoma is rare tumors and till date no such reports with sclera involvement has been reported from Nepal. It is a prospective case series. The aim of this study is for awareness of the severity of the Choroidal melanoma and it’s management. Besides, it is also to study the demography, presentation, histopathological variations and management of cases of choroidal melanoma. All the consecutive cases of Choroidal melanoma presenting between Jan 2017 to May 2018 and those who were within the inclusion criteria were included in this study. Results: There were eight patients, five male and three female, within age range of 18-73, median age was 47. All patients presented with decreased vision ranging from 6/24 to PL of less then three months to 2 years duration. Fund us showed choroidal mass associated with Vitreous hemorrhage (VH), and retinal detachment (RD). Two patients were managed with enucleation with External beam radiotherapy (EBRT). Four underwent only enucleation. One patient with lesion size less then 10mm under went plaque brachy therapy. One patient underwent initially Plaque brachy therapy but later had to undergo Enucleation. Histopathological examination (HPE) of enucleated patient revealed epitheloid cell melanoma grade three in four and Spindle cell melanoma in three patients. Each one patient of epitheloid cell melanoma and spindle cell melanomahad scleral involvement. Indication for radiotherapy was scleral involvement. Conclusion: With 8 cases of Choroidal melanoma in a single year in a single hospitalgives us a clue that there may be much more undiagnosed cases of Choroidal melanomain Nepal that should be taken seriously. Going for annual eye examination with routine dilated fund us exams can help in prevention and early diagnosis of this life and sight threatening condition and to reduce the mortality rate.

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PEComa—A Rare Liver Tumor

Journal of Clinical Medicine ◽

10.3390/jcm10081756 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1756

Author(s):

Marek Krawczyk ◽

Bogna Ziarkiewicz-Wróblewska ◽

Tadeusz Wróblewski ◽

Joanna Podgórska ◽

Jakub Grzybowski ◽

...

Keyword(s):

Liver Resection ◽

Liver Tumor ◽

Spindle Cell ◽

Histopathological Examination ◽

Case Series ◽

Epithelioid Cell ◽

Perivascular Epithelioid Cell ◽

Cell Components ◽

Arterial Vascularization ◽

Radiological Studies

PEComa (perivascular epithelioid cell tumor) is a rare liver tumor. Decisions regarding patient management are currently based on a few small case series. The aim of this study was to report the clinicopathological features of PEComa in order to provide guidance for management, complemented by our own experience. This retrospective observational study included all patients with PEComa who underwent surgical treatment in two departments between 2002 and 2020. A total of 20 patients were diagnosed with PEComa following histopathological examination. The age of the patients ranged from 21 to 73 years. The majority of patients were women (85%). In most patients, the tumors were incidental. In diagnostic studies, PEComas with high arterial vascularization have been described. Liver resection was the treatment of choice. There was only one postoperative complication. During histopathological evaluation, tumors were composed mostly of epithelioid cells, rarely with spindle cell components, thick-walled vessels, and adipocytes in different proportions. Melanocytic markers (HMB45, MelanA) and at least one smooth muscle marker were expressed in all tumors. Features suggestive of malignancy were found in three cases. In conclusion, PEComa is a rare liver tumor that is usually diagnosed incidentally. In radiological studies, tumors with high arterial vascularization are observed. Liver resection is the treatment of choice.

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Oral Propranolol Therapy for Benign Capillary Hemangiomas in a Series of Adult and Pediatric Patients

Philippine Journal of Otolaryngology Head and Neck Surgery ◽

10.32412/pjohns.v32i2.75 ◽

2018 ◽

Vol 32 (2) ◽

pp. 34-37

Author(s):

Gerardo Aniano C. Dimaguila ◽

Emmanuel S. Samson

Keyword(s):

Head And Neck ◽

Pediatric Patients ◽

Case Series ◽

Lesion Size ◽

Capillary Hemangioma ◽

Clinical Resolution ◽

Prospective Case Series ◽

The Right ◽

Propranolol Therapy ◽

Oral Propranolol

Objective: To describe outcomes of oral propranolol therapy in a series of adult and pediatric patients diagnosed with benign capillary hemangioma of the head and neck. Methods: Design: Prospective Case Series Setting: Tertiary Government Hospital Participants: Ten (10) patients representing all patients clinically diagnosed with benign capillary hemangioma of the head and neck, enrolled in the study from 2012 to 2015. Results: Two (2) adults and eight (8) children were enrolled in the study. Although a decrease in lesion size was observed in half of the participants starting at three months, only one (1) attained complete resolution of the lesion-- a 12-year-old girl with hemangioma of the right parotid gland that attained clinical resolution of symptoms after four months of treatment. The remaining nine out of ten (9/10) participants did not attain complete clinical resolution; but there was a decrease in lesion size in four (4) of these participants. For the remaining five (5) participants, there was neither a decrease nor an increase in lesion size. Altogether, of the two adult participants, only one responded to therapy, while only 4 out of 8 pediatric participants responded to therapy. There were no noticeable differences between adult and pediatric patients in terms of resolution and plateau. Aside from mild bradycardia expected with propranolol, no adverse reactions were observed during the course of treatment. Conclusion: Although half of our participants responded to oral propranolol therapy, whether these observations may be attributable to oral propranolol alone cannot be concluded. Keywords: hemangioma, capillary; hemangioma; propranolol administration, oral; propranolol

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Choroidal Nevus and Melanoma in Patients with Oculocutaneous Albinism

Ocular Oncology and Pathology ◽

10.1159/000500784 ◽

2019 ◽

Vol 6 (1) ◽

pp. 31-34

Author(s):

Pukhraj Rishi ◽

Mihir Trivedi ◽

Kummamuri Sreelakshmi

Keyword(s):

Histopathological Examination ◽

Choroidal Melanoma ◽

Case Series ◽

Oculocutaneous Albinism ◽

Large Tumor ◽

Mixed Cell ◽

Asian Patients ◽

Melanocytic Lesions ◽

Choroidal Nevus ◽

The Right

Background: There are limited reports of uveal “melanocytic” lesions in patients with oculocutaneous albinism, with no reports from Asia. Objectives: In this study, we report 3 eyes with uveal “melanocytic” lesions in Asian patients with oculocutaneous albinism. Methods: Retrospective small case series. Three eyes of 2 Asian patients with oculocutaneous albinism were included. Case 1 was a 54-year-old female who presented with juxtapapillary choroidal melanoma and underwent enucleation. Case 2 was a 39-year-old male with pigmented choroidal nevus in the right eye and suspicious nevus/choroidal variegation in the left eye. Results: For case 1, metastatic workup including ultrasound of the abdomen, liver function test, and chest X-ray was unremarkable. Magnetic resonance imaging of the cranium ruled out extraocular extension. The left eye was enucleated due to the large tumor size and poor visual potential, and histopathological examination confirmed the diagnosis of choroidal melanoma with mixed cell type. At the last follow-up 6 months after enucleation, there was no evidence of metastasis. Case 2 was observed. Conclusion: Pigmented choroidal nevus and melanoma are rarely observed in patients with oculocutaneous albinism.

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Micro-CT Imaging of Pediatric Thyroglossal Duct Cysts: A Prospective Case Series

Frontiers in Pediatrics ◽

10.3389/fped.2021.746010 ◽

2021 ◽

Vol 9 ◽

Author(s):

Claire Frauenfelder ◽

Susan C. Shelmerdine ◽

Ian C. Simcock ◽

Andrew Hall ◽

John Ciaran Hutchinson ◽

...

Keyword(s):

3D Imaging ◽

Histopathological Examination ◽

Case Series ◽

Ct Imaging ◽

Thyroglossal Duct Cyst ◽

Micro Ct ◽

Duct Cyst ◽

Thyroglossal Duct ◽

Thyroglossal Duct Cysts ◽

Prospective Case Series

Objectives: To determine the feasibility of micro-CT as a high-resolution 3D imaging tool for thyroglossal duct cysts and to evaluate its role augmenting traditional histopathological examination of resected specimens.Methods: A single centre, prospective case series of consecutive children undergoing excision of a thyroglossal duct cyst was performed at a quaternary paediatric referral hospital in the United Kingdom. Consecutive children listed for excision of a thyroglossal duct cyst whose parents agreed to participate were included and there were no exclusion criteria.Results: Surgically excised thyroglossal duct cyst or remnant specimens from five patients (two males, three females) were examined using micro-CT alongside traditional histopathological examination. In all cases, micro-CT imaging was able to demonstrate 3D imaging datasets of the specimens successfully and direct radio-pathological comparisons were made (Figures 1–5, Supplementary Video 1).Conclusions: The study has shown the feasibility and utility of post-operative micro-CT imaging of thyroglossal duct cysts specimens as a visual aid to traditional histopathological examination. It better informs the pathological specimen sectioning using multi-planar reconstruction and volume rendering tools without tissue destruction. In the complex, often arborised relationship between a thyroglossal duct cyst and the hyoid, micro-CT provides valuable image plane orientation and indicates proximity of the duct to the surgical margins. This is the first case series to explore the use of micro-CT imaging for pediatric thyroglossal duct specimens and it informs future work investigating the generalizability of micro-CT imaging methods for other lesions, particularly those from the head and neck region where precisely defining margins of excision may be challenging.

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