Navegando por Palavras-chave "Choroid neoplasms"
Agora exibindo 1 - 9 de 9
Resultados por página
Opções de Ordenação
- ItemAcesso aberto (Open Access)Achados histopatológicos em retinoblastoma(Conselho Brasileiro de Oftalmologia, 2005-06-01) Souza Filho, João Pessoa de [UNIFESP]; Martins, Maria Cristina [UNIFESP]; Torres, Virgínia Laura [UNIFESP]; Dias, Ana Beatriz Toledo [UNIFESP]; Lowen, Marcia Serva [UNIFESP]; Pires, Luciana Afonso [UNIFESP]; Erwenne, Clélia Maria [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJETIVO: To study histopathological findings of enucleated eyes with retinoblastoma. METHODS: Twenty-eight cases of retinoblastoma treated by enucleation at the Federal University of São Paulo from December 2000 to October 2002 were histopathologically reviewed. Clinical data included age, gender, race, unilateral or bilateral involvement and previous treatment. The histopathological review evaluated the presence of iris and/or angle neovascularization, tumor differentiation and optic nerve and choroidal invasion according to Khelfaoui's classification. RESULTS: Of 27 patients, 13 (48.5%) were boys and 14 (59.3%) were girls, 16 were white, 6 were black and 5 were asiatic, age ranging from 2 to 96 months (mean, 22.7 months). 13 cases were bilateral and 14 cases were unilateral. All tumors were histologically characterized by a proliferation of small cells with high nuclear-to-cytoplasmic ratios and 20 (71.4%) of them were well differentiated. Choroidal involvement was observed in 18 (64.2%) cases (degree II, III) and optic nerve invasion in 8 (28.5%) cases (degree III, IV, V). CONCLUSION: Neovascularization, necrosis and calcification were the most commonly observed feature. The invasion into the optic nerve and choroid, which are the two most important predictors of patient outcome were found in 28.5% and 64.2% of the cases, respectively.
- ItemAcesso aberto (Open Access)Correlação entre a citologia e a histologia nas lesões intra-oculares suspeitas de malignidade(Conselho Brasileiro de Oftalmologia, 2003-06-01) Corrêa, Zélia Maria da Silva [UNIFESP]; Irion, Luciane Dreher; Augsburger, James J.; Schneider, Susan; Erwenne, Clélia Maria [UNIFESP]; Santa Casa de Porto Alegre-RS Serviço de Oftalmologia Setor de Oncologia Oftalmológica; Universidade Federal de São Paulo (UNIFESP); Laboratório Patologistas Reunidos; Universidade de Cincinnati Departamento de Oftalmologia; Universidade de Cincinnati Laboratório de Patologia OcularPURPOSE: To correlate the cytologic findings of fine-needle aspiration biopsy (FNAB) of intraocular tumors with the histopathology specimen when enucleation or tumor resection was the treatment of choice. METHODS: Retrospective analysis of 51 patientssubmitted tofine-needle aspiration biopsy for diagnostic purposes or cyto-histologic correlation. Exclusion criteria were non-solid lesions, conservative treatment and ultrasound guided biopsies. After exclusions, 20 patients with intraocular solid lesions suspected to be malignant were studied, 12 of them were females, with ages between 2 and 78 years. All biopsies were performed by the first author under direct (operating microscope) or indirect (binocular indirect ophthalmoscope) visualization. The chosen route was transaqueous for anterior segment tumors and transvitreous through the sclera for posterior segment tumors except cases with suspicion of retinoblastoma biopsied through the peripheral cornea. Two samples were obtained from different areas of the tumor, in all cases with a 25-gauge needle. After fine-needle aspiration biopsy, samples were sent for processing, fixation, and staining with the Papanicolaou and hematoxylin-eosin (HE) methods. Histology specimens were stained with hematoxylin-eosin. RESULTS: Three cases consisted of anterior segment (iris) tumors and 17 of tumors situated in the posterior segment, 3 of them retinoblastomas. Nine patients were biopsied for diagnostic purposes and 11 for cytological-histological correlation after enucleation. In only two cases, fine-needle aspiration biopsy yielded insufficient material for diagnosis that subsequently proved to be a granuloma and a melanoma. CONCLUSIONS: Fine-needle aspiration biopsy seems to be a reliable procedure based on cytological-histological correlations in the studied group.
- ItemAcesso aberto (Open Access)O diagnóstico do carcinoma metastático de coróide pela biópsia aspirativa com agulha fina (BAAF): relato de caso(Conselho Brasileiro de Oftalmologia, 2003-01-01) Corrêa, Zélia Maria da Silva [UNIFESP]; Irion, Luciane Cristina Dreher; Marcon, Ítalo Mundialino; Goldhardt, Raquel; Travi, Giovanni Marcos; Universidade Federal de São Paulo (UNIFESP); Fundação Faculdade Federal de Ciências Médicas de Porto Alegre; Serviço de Oftalmologia da Santa Casa de Porto Alegre; Santa Casa de Porto AlegrePURPOSE: To report a case of a patient with lung carcinoma in which the first detected metastasis was to the choroid, how it was diagnosed and confirmed. METHODS: A 35 year-old white male, while being treated for a solitary pulmonary condensation, reported sudden loss of vision, pain, discharge and red eye (right eye) for 10 days. During the ophthalmic examination a nonregmatogenous retinal detachment as well as multiple choroidal tumors were confirmed by diagnostic ocular ultrasound. Fine-needle aspiration biopsy (FNAB) was suggested to diagnose a possible metastatic disease. Fine-needle aspiration biopsy was performed under peribulbar anesthesia with sedation. A transvitreous route was chosen through a sclerotomy 4 mm from the limbus. The procedure was monitored via binocular indirect ophthalmoscopy. Two sample aspirates were obtained from different tumour foci. After fine-needle aspiration biopsy, the aspirates were sent for processing, fixation and stained with Papanicolaou and HE. RESULTS: Cytology confirmed the diagnosis of multiple metastatic tumors. Immunocytochemistry of ocular and lung aspirates revealed a common cell origin by a pankeratin (AE1/AE3) positive test. Regardless of systemic treatment with chemotherapy and improvement of the ocular status, the patient died 4 months after cytological diagnosis of metastatic carcinoma of the choroid. CONCLUSIONS: Fine-needle aspiration biopsy was efficient to diagnose and correlate ocular cytology with the primary tumor by imunohistochemical methods in this case. Fine-needle aspiration biopsy should still be used only in selected cases and further research will be necessary for it to become a standard diagnostic procedure in ophthalmology.
- ItemAcesso aberto (Open Access)Estudo comparativo da flarefotometria em pacientes com melanoma maligno e nevo de coróide(Conselho Brasileiro de Oftalmologia, 2002-01-01) Ballalai, Priscilla Luppi [UNIFESP]; Erwenne, Clélia Maria [UNIFESP]; Chojniak, Martha Motono; Universidade Federal de São Paulo (UNIFESP); Hospital A C Camargo Departamento de Tumores OcularesIntroduction: Malignant intraocular tumors are associated with an increase in the aqueous flare, caused by alterations of the blood-ocular barriers through various mechanisms. Several studies have demonstrated an ocular flare increase using flare photometry in eyes with benign and malignant tumors. Purpose: To evaluate flare photometry as an adjunct method in the differential diagnosis of choroidal malignant melanoma and choroidal nevus comparing to normal control eyes. Methods: Eyes with melanoma and nevus were diagnosed by indirect binocular ophthalmoscopy and/or ultrasound were evaluated. The fellow normal eyes were used as a control. In all subject and control eyes flare photometry was performed using the Laser Flare Meter (FC 500, Kowa), under mydriasis. Statistical analysis was done using the Wilcoxon, Mann-Whitney, and Spearman tests. Results: Thirty-one eyes with malignant melanoma and 18 eyes with nevus were evaluated. The flare photometry average in the eyes with malignant melanoma was 17.1 ph/ms and in the control fellow eyes it was 4.06 ph/ms. In eyes with choroidal nevus the flare photometry average was 6.12 ph/ms and in the control fellow eyes it was 4.47 ph/ms. The flare photometry was higher in eyes with malignant melanoma and nevus than in the fellow normal eyes (p<0.001 and p<0.01). Comparing the eyes with malignant melanoma and nevus, flare photometry was significantly higher in eyes with malignant melanoma (p<0.001). There was a positive correlation between the tumor thickness and flare photometry (r=0.47). Conclusion: Flare photometry is a helpful tool in the differential diagnosis of malignant melanoma and choroidal nevus.
- ItemAcesso aberto (Open Access)Invasão do nervo óptico por melanoma peripapilar: relato de caso(Conselho Brasileiro de Oftalmologia, 2003-06-01) Marback, Eduardo Ferrari [UNIFESP]; Arias, Victor Eduardo Aruá; Gonzaga, Renato Luiz [UNIFESP]; Pinto, Clóvis Antônio; Erwenne, Clélia Maria [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Fundação Antônio Prudente Hospital do Câncer Departamento de Anatomia Patológica; Universidade de São Paulo (USP)Small-pigmented lesions over the optic disc are very rare and may represent a diagnostic challenge. To report a case of a small malignant choroidal melanoma invading the optic nerve. A 60-year-old male presents with low vision in the left eye due to a small, pigmented lesion over the optic disc. At first the patient refused enucleation. One month later, after further drop in visual acuity, the patient was seen at another service, diagnosed as having a retinal detachment, and pars plana vitrectomy was proposed but also refused by the patient. Returning to our service, the eye was enucleated and a final diagnosis of choroidal melanoma with post-laminar optic nerve invasion was made. Although rare, pigmented lesions over the optic disc may represent a malignant melanoma. The prognostic significance of optic nerve invasion by choroidal melanoma is not clear yet. The differential diagnosis in these cases is usually difficult but a solid lesion is clear at ultrasonography and serous retinal detachment may predict a active tumor lesion. The management of these cases needs accuracy to avoid the unpleasant consequences of dissemination.
- ItemAcesso aberto (Open Access)Síndrome mascarada como primeira manifestação de adenocarcinoma pulmonar: relato de caso e revisão de literatura(Conselho Brasileiro de Oftalmologia, 2003-01-01) Farias, Charles Costa De; Garcia, Claudio Renato; Muccioli, Cristina [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To describe a case of masquerade syndrome as the first manifestation of lung adenocarcinoma. METHODS: A 57- year-old female was referred with a 6-month history of blurred vision in her right eye. She was treated for relapsing uveitis but signs and symptons remained despite treatment with topical steroids. On physical examination she had conjuctival hyperemia, moderate cilliary injection and choroidal peripapillary lesion. Ancillary examinations were requested. RESULTS: A lung adenocacirnoma was diagnosed as the primary lesion. The choroidal peripapillary lesion in her right eye was consistent with the appearance of a choroidal metastatic lesion. CONCLUSIONS: The incidence of uveal metastasis ranges from 0.7 to 12% in patients with pulmonary tumors. Treatment depends on characteristics such as size of the lesion, number of metastases, visual acuity, bilaterality and the patient´s general health. As confirmed by this case, ocular involvement may be the first clinical manifestation of lung adenocarcinoma.
- ItemAcesso aberto (Open Access)Single institutional retrospective analysis: treatment of choroidal melanomas with cobalt-60 brachytherapy(Conselho Brasileiro de Oftalmologia, 2004-06-01) Pellizzon, Antônio Cássio Assis; Salvajoli, João Victor; Novaes, Paulo Eduardo; Fogaroli, Ricardo; Ferrigno, Robson; Maia, Maria Aparecida Conte; Chojniak, Marta Motono; Erwene, Clélia Maria [UNIFESP]; Hospital do Câncer - AC Camargo Centro de Tratamento Pesquisa Department of Radiation Oncology; Instituto Arnaldo Vieira de Carvalho; Hospital do Câncer - AC Camargo Centro de Tratamento Pesquisa Department of Onco-opthalmology; Universidade Federal de São Paulo (UNIFESP)PURPOSE: To evaluate the outcome of patients with choroidal melanoma treated with conservative therapy with brachytherapy (episcleral Co-60 plaque therapy) at the Hospital do Cancer São Paulo, Brazil. METHODS: We evaluated 102 patients consecutively treated from January, 1999 to June, 1999. Median age, maximum tumor base diameter and apex size were 55.5 years, 9.75 mm and 5 mm, respectively. Doses at the base of the tumor, including 1 mm of sclera, ranged from 157 to 487 Gy (median 284.5 Gy) and to the apex from 37 to 220 Gy (median 106 Gy). RESULTS: The crude eye preservation rate with conservative therapy alone was 78.5%. Five-year overall actuarial survival rate was 92.2% and eye conservation rate was 78%. Side effects were mostly an uncomplicated retinopathy in 39/102 patients (38.2%); macular degeneration or scarring led to poor central vision in 31/102 patients (30.3%) of cases. CONCLUSION: Our experience with cobalt-60 plaque brachytherapy achieved a satisfactory rate of local tumor control, despite the oversized base diameters of treated tumors.
- ItemAcesso aberto (Open Access)Termoterapia transpupilar em melanoma maligno da coróide(Conselho Brasileiro de Oftalmologia, 2001-04-01) Chojniak, Martha M. Motomo [UNIFESP]; Guia, Tércio [UNIFESP]; Uno, Fausto [UNIFESP]; Erwenne, Clélia Maria [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Hospital A. C. Camargo; Hospital A. C. Camargo Setor de TumoresPurpose: Several methods have been used for treatment of choroidal melanoma. The purpose of this preliminary paper is to evaluate the effectiveness of transpupillary thermo- therapy (TTT) as a primary treatment of small choroidal melanomas. Methods: This is a prospective nonrandomized study evaluating clinical aspects, tumor response, complications and visual outcome in patients presenting small choroidal melanomas (up to 4.0 mm thick and 12 mm base diameter) treated with TTT over 810 nm laser diode applications. Results: There were 11 patients treated with trans-pupillary thermotherapy, all of them presenting pig-mented small choroidal melanomas. Growth previous to treatment was documented in 5 patients and risk factors for growth or metastatic disease was present in all the patients. After treatment the patients were followed for 3 to 8 months (mean 5.7 months). Three laser sessions were used in 5 pa-tients and 4 sessions in 6 patients. The lesions presented at the beginning of the treatment a mean thickness of 2.7 mm, with a mean larger base diameter of 7.8 mm. All the lesions responded to treatment and presented decrease of thickness and base diameters. After transpupillary thermotherapy, the lesions' mean thickness was 1.8 mm and the mean larger base diameter was 6.7 mm. The mean reduction in thickness was 0.9 mm and the mean decrease in larger base diameter was 1.4 mm. The visual acuity remained unaffected in 5 cases and worsened after treatment in 6 cases. Nine patients presented compli- cations. A major complication occurred in a single patient who presented retinal detachment. Minor compli-cations were observed as follows: small retinal hemorrhages (7 patients), vitreous inflammation associated with tenuous vitreous membranes (1 patient) and conjunctiva and eyelid edema (1 patient). Local tumor control and conservation of the eyeball was accomplished in all the patients; they are all alive without evidence of metastatic disease in this initial follow-up period. Conclusion: This preliminary study suggests that the transpupillary thermotherapy is a promi-sing, effective and safe method for treatment of selected small choroidal melanomas. Further studies with longer follow-up period are necessary to better evaluate this treatment.
- ItemAcesso aberto (Open Access)O uso da biópsia aspirativa com agulha fina (BAAF) no diagnóstico de lesão iriana suspeita: relato de caso(Conselho Brasileiro de Oftalmologia, 2001-08-01) Corrêa, Zélia Maria da Silva [UNIFESP]; Marcon, Ítalo Mundialino [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Faculdade Federal de Ciências Médicas de Porto AlegreTo report the case of a patient who presented with a solid anterior segment intraocular mass in his right eye, and the diagnostic investigation chosen by the authors. Diagnostic uncertainty and patient's refusal to agree with the treatment caused the authors to perform a fine needle aspiration biopsy of the lesion. Biopsy was performed by corneal puncture, through the aqueous and the tumor. Cytology of the specimen obtained by the biopsy determined the therapeutic strategy for this case. Cytology diagnosis was consistent with primary malignant melanoma of the choroid of mixed cell type. Enucleation of the eye was suggested due to the position of the tumor and its potential to spread distant metastases. After enucleation, anatomopathological examination of the eye presented a similar result to cytology. The patient is currently been followed, with no signs of metastasis 2 years after enucleation.