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Bita Esmaeli - One of the best experts on this subject based on the ideXlab platform.
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prognostic factors for local recurrence and survival and impact of local treatments on survival in lacrimal gland carcinoma
British Journal of Ophthalmology, 2021Co-Authors: Joshua Ford, Steven J. Frank, Diana Bell, Renata Ferrarotto, Maria Laura Rubin, Jing Ning, James Matthew Debnam, Adel K Elnaggar, Bita EsmaeliAbstract:Background/aims To identify prognostic factors for local recurrence, distant metastasis and disease-specific survival (DSS) for lacrimal gland carcinoma. Methods All consecutive patients with lacrimal gland carcinoma treated from January 1998 through December 2018 were included. Log-rank tests and univariate Cox proportional hazards regression models were used to study risk factors and survival. Results Overall, 55 patients were included in this study, and 5 patients were excluded from the survival analysis. Median age was 46 years (range: 10–76). 43 patients (78%) had adenoid cystic carcinoma (ACC). 31 patients (56%) had T2 disease at presentation. 28 patients (51%) underwent Orbital Exenteration with or without adjuvant radiotherapy or chemoradiation, 26 (47%) underwent eye-sparing surgery with or without adjuvant radiotherapy or chemoradiation, and 1 received palliative chemoradiation. 11 patients (22%) experienced local recurrence; 14 (29%) experienced distant metastasis. Five- and 10-year local-recurrence-free survival rates were 0.71 (95% CI 0.58 to 0.88), and 5- and 10-year distant-metastasis-free survival rates were 0.67 (95% CI 0.53 to 0.85) and 0.49 (95% CI 0.30 to 0.81), respectively. There was no significant difference in risks of local recurrence, distant metastasis or DSS between ACC patients who had Orbital Exenteration and those who had eye-sparing surgery. Perineural invasion was negatively associated with local-recurrence-free survival (p=0.02). Among patients with ACC, basaloid/solid histologic type was associated with significantly worse DSS than non-basaloid/solid histologic type (p Conclusions For lacrimal gland carcinoma, Orbital Exenteration with adjuvant therapy and eye-sparing surgery with adjuvant therapy are associated with similar recurrence outcomes. Eye-sparing surgery is associated with better DSS. Perineural invasion is a risk factor for local recurrence. ACC with basaloid/solid subtype correlates with worse DSS.
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prognostic factors for Orbital Exenteration local recurrence metastasis and death from disease in conjunctival squamous cell carcinoma
Ophthalmic Plastic and Reconstructive Surgery, 2020Co-Authors: Christian Elhadad, Maria Laura Rubin, Priya Nagarajan, Joshua Ford, Jing Ning, Bita EsmaeliAbstract:PURPOSE Information regarding risk of metastasis and disease-related death (DD) from conjunctival squamous cell carcinoma (SCC) is relatively scarce. We explored prognostic factors for Orbital Exenteration, local recurrence, nodal metastasis, and DD in patients with conjunctival SCC. DESIGN Retrospective cross-sectional study. METHODS All consecutive patients with conjunctival SCC treated by the senior author at MD Anderson Cancer Center during1999-2018 were included. Survival curves were estimated using the Kaplan-Meier method, and survival differences were assessed using 2-sided log-rank tests. RESULTS The study included 44 patients (24 men, 20 women); median age was 64 years (range, 40-90). T categories at presentation were as follows: Tis, 20 patients; T2, 8; T3, 9; and T4, 7. Eighteen patients (41%) had tumors exclusively in the bulbar conjunctiva; 26(59%) had nonbulbar conjunctival involvement. The median follow-up time was 29.2 months (95% CI: 21.8-44.3). Orbital Exenteration was performed in 10 cases (23%) and was associated with T3 or more advanced disease at presentation (p < 0.001). Seven patients developed local recurrence during follow up. History of organ transplant correlated with local recurrence and Orbital Exenteration (p < 0.01). Nodal metastasis was present in 1 patient at presentation and occurred in 3 patients during follow up, for an overall nodal metastasis rate of 9% (4/44). By end of follow up, 2 patients had died of disease, 4 had died of other causes, and 38 were alive with no evidence of disease. The results suggest that both Orbital Exenteration and nodal metastasis are independent variables associated with DD. CONCLUSIONS In patients with conjunctival SCC, Orbital Exenteration and nodal metastasis are associated with DD and organ transplantation is associated with Orbital Exenteration.
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impact of food and drug administration approval of vismodegib on prevalence of Orbital Exenteration as a necessary surgical treatment for locally advanced periocular basal cell carcinoma
Ophthalmic Plastic and Reconstructive Surgery, 2019Co-Authors: Oded Sagiv, Stephanie Ding, Renata Ferrarotto, Bonnie S Glisson, Mehmet Altan, Faye M Johnson, Yasir Y Elamin, Sudip D Thakar, Priyadharsini Nagarajan, Bita EsmaeliAbstract:Purpose To test the hypothesis that the US Food and Drug Administration approval of vismodegib in early 2012 has reduced the prevalence of Orbital Exenteration for locally advanced periocular basal cell carcinoma (BCC). Methods Following institutional review board approval, the authors reviewed clinical and pathological data of patients with locally advanced periocular BCC (T4 per the eyelid carcinoma classification in the 8th edition of the AJCC Cancer Staging Manual) treated by the senior author during 2006-2018. Patients were grouped into those who were treated before February 2012 ("before vismodegib approval") and those who presented later ("after vismodegib approval"). Results Forty-two patients with locally advanced periocular BCC were treated during the study period, of whom 31 were men. The median age at presentation was 66 years (range, 43-90). Twenty-two patients had T4a and 20 had T4b tumors. Thirteen patients were treated before and 29 were treated after vismodegib approval. The 2 groups did not differ in age distribution (p = 0.164), sex distribution (p = 0.270), prevalence of recurrent tumor at presentation (p = 0.317), or duration of treatment with vismodegib (p = 0.605). Orbital Exenteration was significantly more prevalent in patients treated before vismodegib approval than after (46% vs. 10%, p = 0.016), and vismodegib treatment was significantly more prevalent in patients treated after vismodegib approval than before (when vismodegib was given in clinical trials; 69% vs. 23%, p = 0.008). There was a trend toward more patients retaining their eyes at last follow-up in patients treated after vismodegib approval (83% vs. 54%, p = 0.066). Conclusions The prevalence of Orbital Exenteration as a necessary surgical procedure in patients with a locally advanced periocular BCC has fallen since the Food and Drug Administration approval of vismodegib. Although vismodegib is not specifically approved for organ-sparing, it has changed the authors' practice and enabled eye preservation in patients with locally advanced periocular BCC, who would otherwise require an Orbital Exenteration.
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current treatment of lacrimal gland carcinoma
Current Opinion in Ophthalmology, 2016Co-Authors: Kyung In Woo, Yoon Duck Kim, Bita EsmaeliAbstract:Purpose of reviewThe traditional treatment for lacrimal gland carcinoma is Orbital Exenteration followed by radiation therapy. However, Orbital Exenteration does not prevent distant relapse and death, and some patients experience local–regional recurrence after Exenteration. More recently, eye-spari
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hedgehog pathway inhibition for locally advanced periocular basal cell carcinoma and basal cell nevus syndrome
American Journal of Ophthalmology, 2015Co-Authors: Omar Ozgur, Vivian T Yin, Eva Chou, Sharon Ball, Merrill S Kies, William N William, Michael R Migden, Bradley A Thuro, Bita EsmaeliAbstract:Purpose To review our experience treating patients with the Hedgehog pathway inhibitor, vismodegib, in patients with Orbital or periocular locally advanced or metastatic basal cell carcinoma (BCC) or basal cell nevus syndrome. Design Retrospective interventional case series. Methods We reviewed all patients with locally advanced or metastatic Orbital or periocular BCC or basal cell nevus syndrome treated with the Hedgehog pathway inhibitor, vismodegib, at a comprehensive cancer center from 2009 through 2015. Reviewed data included age; sex; American Joint Commission on Cancer tumor, node, metastasis staging system designation; type and grade of drug-related side effects; response to treatment; duration of follow-up, and status at last follow-up. Results The study included 10 white men and 2 white women; the median age was 64.5 years. Ten patients had locally advanced BCC; 2 had basal cell nevus syndrome. Among the patients with locally advanced BCC, 5 had T3bN0M0 disease at presentation; 1 each had T3aN0M0, T3bN1M0, T2N1M1, T4N1M1, and T4N2cM1 disease. Overall, 3 patients had a complete response, 6 had a partial response, and 3 had stable disease at last follow-up. Two patients developed progressive disease after a complete response for 38 months and stable disease for 16 months, respectively. All patients developed grade I drug-related adverse effects, most commonly muscle spasms (12 patients), weight loss (10), dysgeusia (9), alopecia (9), decreased appetite (5), and fatigue (4). Five patients developed grade II adverse effects. At last follow-up, none of the 5 patients presenting with T3bN0M0, nor the patient with T3bN1M0 disease, had required Orbital Exenteration. Conclusion Hedgehog pathway inhibition produces a significant clinical response in most patients with locally advanced or metastatic Orbital or periocular BCC or basal cell nevus syndrome and can obviate Orbital Exenteration in some patients. Drug-related adverse effects are manageable in most patients.
Seong Yoon Lim - One of the best experts on this subject based on the ideXlab platform.
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reconstruction after Orbital Exenteration using gracilis muscle free flap
Microsurgery, 2015Co-Authors: Fabio Nicoli, Ram M Chilgar, Stamatis Sapountzis, Matthew Szewei Yeo, Davide Lazzeri, Pedro Ciudad, Kidakorn Kiranantawat, Tolga Taha Sonmez, Michele Maruccia, Seong Yoon LimAbstract:Background Orbital Exenteration (OE) is a disfiguring procedure, which typically includes the removal of the entire eyeball including the globe, extraocular muscles, and periOrbital soft tissues after malignancies excision or trauma. Several methods of Orbital reconstruction have been attempted with varying success. In this report, we analyze results of the use of gracilis muscle free flap for reconstruction of OE defects and its feasibility for prosthetic rehabilitation. Methods Nine consecutive patients treated at the China Medical University Hospital of Taichung during January 2009 to January 2013, who had gracilis free flap reconstruction after OEs, were retrospectively reviewed. Cancer in six patients and trauma in remaining three patients was the cause for OE. Results Nine patients who underwent reconstruction with gracilis free tissue transfer had a successful outcome. There was not any donor or recipient site morbidity; however, one patient was deceased during follow-up period due to metastasis. The mean follow-up period was 23.5 months. Cosmetic results were acceptable both to patients and to surgeons. Conclusions Gracilis free flap to repair OE defects may be a safe alternative for reconstruction. It provides a larger volume of well-vascularized tissue, greater placement flexibility, and minor donor site morbidity without any significant functional deficit. © 2014 Wiley Periodicals, Inc. Microsurgery 35:169–176, 2015.
Mauricio Veloso Brun - One of the best experts on this subject based on the ideXlab platform.
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melanoma de iris corpo ciliar e coroide em um cao da raca poodle
Acta Scientiae Veterinariae, 2016Co-Authors: Luis Felipe Dutra Correa, Rafael Oliveira Chaves, Marilia Teresa De Oliveira, J P S Feranti, Bruna Copat, Dakir Polidoro Neto, Ney Luis Pippi, Mauricio Veloso BrunAbstract:Background: Melanoma is a primary ocular neoplasm that may affect the iris, ciliary body, the choroid coat and others components of the eye. The ocular melanomas have a low metastatic level in dogs when compared to cats. Old animals are more affected than the young ones and there is no breed predilection. A complete eye examination and ocular ultrasound will lead to the diagnosis that will be further confirmed through histopathology. Current treatment of choice is based on the size and the structures involved by the tumor that can range from local resection to Orbital Exenteration. The objective of this study is to report a case of iris melanoma involving the ciliary body and the choroid coat of a Poodle, emphasizing its clinical manifestation, diagnosis and treatment. Case: This study reports a case of an intact male canine Poodle, 15 years old, weighing 5 kg that was referred for care to the Veterinary Teaching Hospital of the Federal University of Santa Maria, Brazil. The owner initially presented a history of a progressive increase dark-colored intraocular volume in the right eye iris of the dog. On the clinical examination, no abnormality was found. On the ophthalmic examination, the right eye possessed misshapen pupil, hyperemia ocular conjunctiva (+) and diffuse corneal opacity (+) with paracentral pigmentation between 7-10 hour. On biomicroscopic examination, using a slit lamp, it was observed an iris distension that was protruding directly into the anterior chamber and a diffuse opacity of the lens. Intraocular pressure was eight mmHg. B-mode ultrasonography revealed a mass involving the iris, ciliary body and the choroid coat with perilesional retinal detachment, suggesting iris ciliary body and choroid melanoma. Due to the bad prognosis of the affected eye, the patient underwent to Orbital Exenteration procedure. The extracted eyeball was placed in 10% formalin and sent for histopathological examination, which was later reported as showing an iris melanoma involving the ciliary body and the choroid coat. The patient was re-examined six months postoperatively and no neoplasm recurrence signs were observed. Discussion: The animal stated in this report showed an increased volume of the right eye and dark pigmentation involving the iris. As highlighted by the actual literature, the size of this kind of neoplasm can vary from small to larger nodules and it can causes relevant anatomical changes. The pigmentation in these cases may vary from dark colors (black or brown) to white, for example, the amelanotic melanomas. In this report it was observed a nodular staining quite blackened pigmentation. This kind of cancer involves mainly not neutered male dogs, with breed predilection as the German shepherd dogs, Golden Retrievers, Labrador Retrievers and also Poodles, as reported in this case. The treatment suggested by the literature, can range from diode laser therapy to microsurgical resection with enucleation or Exenteration, depending on the size of the affected region and structures involved. The treatment of choice in this patient was the Orbital Exenteration because of the capacity of this tumor to spread throughout the uvea and it was not sure whether scleral infiltration could already exist, although the enucleation could also be indicated. However, through the histopathological examination, it could be confirmed that the neoplasm was located only at iris, involving also the ciliary body and choroid coat without sclera leakage, so there would be no need for Exenteration. The average age of the patients is around nine years old according to published reports, namely older animals as the patient here described. The Orbital Exenteration technique, with good safety margin resection, proved to be efficient for the surgical treatment of iris melanoma involving the ciliary body and the choroid coat.
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melanoma de iris corpo ciliar e coroide em um cao da raca poodle melanoma of the iris ciliary body and choroid in a dog s poodle
2016Co-Authors: Luis Felipe Dutra Correa, Rafael Oliveira Chaves, Marilia Teresa De Oliveira, J P S Feranti, Bruna Copat, Ney Luis Pippi, Dakir Nilton, Polidoro Neto, Mauricio Veloso BrunAbstract:Background: Melanoma is a primary ocular neoplasm that may affect the iris, ciliary body, the choroid coat and others components of the eye. The ocular melanomas have a low metastatic level in dogs when compared to cats. Old animals are more affected than the young ones and there is no breed predilection. A complete eye examination and ocular ultrasound will lead to the diagnosis that will be further confirmed through histopathology. Current treatment of choice is based on the size and the structures involved by the tumor that can range from local resection to Orbital Exenteration. The objective of this study is to report a case of iris melanoma involving the ciliary body and the choroid coat of a Poodle, emphasizing its clinical manifestation, diagnosis and treatment. Case: This study reports a case of an intact male canine Poodle, 15 years old, weighing 5 kg that was referred for care to the Veterinary Teaching Hospital of the Federal University of Santa Maria, Brazil. The owner initially presented a history of a progressive increase dark-colored intraocular volume in the right eye iris of the dog. On the clinical examination, no abnormality was found. On the ophthalmic examination, the right eye possessed misshapen pupil, hyperemia ocular conjunctiva (+) and diffuse corneal opacity (+) with paracentral pigmentation between 7-10 hour. On biomicroscopic examination, using a slit lamp, it was observed an iris distension that was protruding directly into the anterior chamber and a diffuse opacity of the lens. Intraocular pressure was eight mmHg. B-mode ultrasonography revealed a mass involving the iris, ciliary body and the choroid coat with perilesional retinal detachment, suggesting iris ciliary body and choroid melanoma. Due to the bad prognosis of the affected eye, the patient underwent to Orbital Exenteration procedure. The extracted eyeball was placed in 10% formalin and sent for histopathological examination, which was later reported as showing an iris melanoma involving the ciliary body and the choroid coat. The patient was re-examined six months postoperatively and no neoplasm recurrence signs were observed. Discussion: The animal stated in this report showed an increased volume of the right eye and dark pigmentation involving the iris. As highlighted by the actual literature, the size of this kind of neoplasm can vary from small to larger nodules and it can causes relevant anatomical changes. The pigmentation in these cases may vary from dark colors (black or brown) to white, for example, the amelanotic melanomas. In this report it was observed a nodular staining quite blackened pigmentation. This kind of cancer involves mainly not neutered male dogs, with breed predilection as the German shepherd dogs, Golden Retrievers, Labrador Retrievers and also Poodles, as reported in this case. The treatment suggested by the literature, can range from diode laser therapy to microsurgical resection with enucleation or Exenteration, depending on the size of the affected region and structures involved. The treatment of choice in this patient was the Orbital Exenteration because of the capacity of this tumor to spread throughout the uvea and it was not sure whether scleral infiltration could already exist, although the enucleation could also be indicated. However, through the histopathological examination, it could be confirmed that the neoplasm was located only at iris, involving also the ciliary body and choroid coat without sclera leakage, so there would be no need for Exenteration. The average age of the patients is around nine years old according to published reports, namely older animals as the patient here described. The Orbital Exenteration technique, with good safety margin resection, proved to be efficient for the surgical treatment of iris melanoma involving the ciliary body
Luis Felipe Dutra Correa - One of the best experts on this subject based on the ideXlab platform.
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melanoma of the iris ciliary body and choroid in a dog s poodle
Acta Scientiae Veterinariae, 2016Co-Authors: Luis Felipe Dutra Correa, Rafael Oliveira Chaves, Marilia Teresa De Oliveira, J P S Feranti, Bruna Copat, Dakir Polidoro Neto, Ney Luis PippiAbstract:Background : Melanoma is a primary ocular neoplasm that may affect the iris, ciliary body, the choroid coat and others components of the eye. The ocular melanomas have a low metastatic level in dogs when compared to cats. Old animals are more affected than the young ones and there is no breed predilection. A complete eye examination and ocular ultrasound will lead to the diagnosis that will be further confirmed through histopathology. Current treatment of choice is based on the size and the structures involved by the tumor that can range from local resection to Orbital Exenteration. The objective of this study is to report a case of iris melanoma involving the ciliary body and the choroid coat of a Poodle, emphasizing its clinical manifestation, diagnosis and treatment. Case : This study reports a case of an intact male canine Poodle, 15 years old, weighing 5 kg that was referred for care to the Veterinary Teaching Hospital of the Federal University of Santa Maria, Brazil. The owner initially presented a history of a progressive increase dark-colored intraocular volume in the right eye iris of the dog. On the clinical examination, no abnormality was found. On the ophthalmic examination, the right eye possessed misshapen pupil, hyperemia ocular conjunctiva (+) and diffuse corneal opacity (+) with paracentral pigmentation between 7-10 hour. On biomicroscopic examination, using a slit lamp, it was observed an iris distension that was protruding directly into the anterior chamber and a diffuse opacity of the lens. Intraocular pressure was eight mmHg. B-mode ultrasonography revealed a mass involving the iris, ciliary body and the choroid coat with perilesional retinal detachment, suggesting iris ciliary body and choroid melanoma. Due to the bad prognosis of the affected eye, the patient underwent to Orbital Exenteration procedure. The extracted eyeball was placed in 10% formalin and sent for histopathological examination, which was later reported as showing an iris melanoma involving the ciliary body and the choroid coat. The patient was re-examined six months postoperatively and no neoplasm recurrence signs were observed. Discussion : The animal stated in this report showed an increased volume of the right eye and dark pigmentation involving the iris. As highlighted by the actual literature, the size of this kind of neoplasm can vary from small to larger nodules and it can causes relevant anatomical changes. The pigmentation in these cases may vary from dark colors (black or brown) to white, for example, the amelanotic melanomas. In this report it was observed a nodular staining quite blackened pigmentation. This kind of cancer involves mainly not neutered male dogs, with breed predilection as the German shepherd dogs, Golden Retrievers, Labrador Retrievers and also Poodles, as reported in this case. The treatment suggested by the literature, can range from diode laser therapy to microsurgical resection with enucleation or Exenteration, depending on the size of the affected region and structures involved. The treatment of choice in this patient was the Orbital Exenteration because of the capacity of this tumor to spread throughout the uvea and it was not sure whether scleral infiltration could already exist, although the enucleation could also be indicated. However, through the histopathological examination, it could be confirmed that the neoplasm was located only at iris, involving also the ciliary body and choroid coat without sclera leakage, so there would be no need for Exenteration. The average age of the patients is around nine years old according to published reports, namely older animals as the patient here described. The Orbital Exenteration technique, with good safety margin resection, proved to be efficient for the surgical treatment of iris melanoma involving the ciliary body and the choroid coat. Keywords: ophthalmology, neoplasm, uvea.
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melanoma de iris corpo ciliar e coroide em um cao da raca poodle
Acta Scientiae Veterinariae, 2016Co-Authors: Luis Felipe Dutra Correa, Rafael Oliveira Chaves, Marilia Teresa De Oliveira, J P S Feranti, Bruna Copat, Dakir Polidoro Neto, Ney Luis Pippi, Mauricio Veloso BrunAbstract:Background: Melanoma is a primary ocular neoplasm that may affect the iris, ciliary body, the choroid coat and others components of the eye. The ocular melanomas have a low metastatic level in dogs when compared to cats. Old animals are more affected than the young ones and there is no breed predilection. A complete eye examination and ocular ultrasound will lead to the diagnosis that will be further confirmed through histopathology. Current treatment of choice is based on the size and the structures involved by the tumor that can range from local resection to Orbital Exenteration. The objective of this study is to report a case of iris melanoma involving the ciliary body and the choroid coat of a Poodle, emphasizing its clinical manifestation, diagnosis and treatment. Case: This study reports a case of an intact male canine Poodle, 15 years old, weighing 5 kg that was referred for care to the Veterinary Teaching Hospital of the Federal University of Santa Maria, Brazil. The owner initially presented a history of a progressive increase dark-colored intraocular volume in the right eye iris of the dog. On the clinical examination, no abnormality was found. On the ophthalmic examination, the right eye possessed misshapen pupil, hyperemia ocular conjunctiva (+) and diffuse corneal opacity (+) with paracentral pigmentation between 7-10 hour. On biomicroscopic examination, using a slit lamp, it was observed an iris distension that was protruding directly into the anterior chamber and a diffuse opacity of the lens. Intraocular pressure was eight mmHg. B-mode ultrasonography revealed a mass involving the iris, ciliary body and the choroid coat with perilesional retinal detachment, suggesting iris ciliary body and choroid melanoma. Due to the bad prognosis of the affected eye, the patient underwent to Orbital Exenteration procedure. The extracted eyeball was placed in 10% formalin and sent for histopathological examination, which was later reported as showing an iris melanoma involving the ciliary body and the choroid coat. The patient was re-examined six months postoperatively and no neoplasm recurrence signs were observed. Discussion: The animal stated in this report showed an increased volume of the right eye and dark pigmentation involving the iris. As highlighted by the actual literature, the size of this kind of neoplasm can vary from small to larger nodules and it can causes relevant anatomical changes. The pigmentation in these cases may vary from dark colors (black or brown) to white, for example, the amelanotic melanomas. In this report it was observed a nodular staining quite blackened pigmentation. This kind of cancer involves mainly not neutered male dogs, with breed predilection as the German shepherd dogs, Golden Retrievers, Labrador Retrievers and also Poodles, as reported in this case. The treatment suggested by the literature, can range from diode laser therapy to microsurgical resection with enucleation or Exenteration, depending on the size of the affected region and structures involved. The treatment of choice in this patient was the Orbital Exenteration because of the capacity of this tumor to spread throughout the uvea and it was not sure whether scleral infiltration could already exist, although the enucleation could also be indicated. However, through the histopathological examination, it could be confirmed that the neoplasm was located only at iris, involving also the ciliary body and choroid coat without sclera leakage, so there would be no need for Exenteration. The average age of the patients is around nine years old according to published reports, namely older animals as the patient here described. The Orbital Exenteration technique, with good safety margin resection, proved to be efficient for the surgical treatment of iris melanoma involving the ciliary body and the choroid coat.
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melanoma de iris corpo ciliar e coroide em um cao da raca poodle melanoma of the iris ciliary body and choroid in a dog s poodle
2016Co-Authors: Luis Felipe Dutra Correa, Rafael Oliveira Chaves, Marilia Teresa De Oliveira, J P S Feranti, Bruna Copat, Ney Luis Pippi, Dakir Nilton, Polidoro Neto, Mauricio Veloso BrunAbstract:Background: Melanoma is a primary ocular neoplasm that may affect the iris, ciliary body, the choroid coat and others components of the eye. The ocular melanomas have a low metastatic level in dogs when compared to cats. Old animals are more affected than the young ones and there is no breed predilection. A complete eye examination and ocular ultrasound will lead to the diagnosis that will be further confirmed through histopathology. Current treatment of choice is based on the size and the structures involved by the tumor that can range from local resection to Orbital Exenteration. The objective of this study is to report a case of iris melanoma involving the ciliary body and the choroid coat of a Poodle, emphasizing its clinical manifestation, diagnosis and treatment. Case: This study reports a case of an intact male canine Poodle, 15 years old, weighing 5 kg that was referred for care to the Veterinary Teaching Hospital of the Federal University of Santa Maria, Brazil. The owner initially presented a history of a progressive increase dark-colored intraocular volume in the right eye iris of the dog. On the clinical examination, no abnormality was found. On the ophthalmic examination, the right eye possessed misshapen pupil, hyperemia ocular conjunctiva (+) and diffuse corneal opacity (+) with paracentral pigmentation between 7-10 hour. On biomicroscopic examination, using a slit lamp, it was observed an iris distension that was protruding directly into the anterior chamber and a diffuse opacity of the lens. Intraocular pressure was eight mmHg. B-mode ultrasonography revealed a mass involving the iris, ciliary body and the choroid coat with perilesional retinal detachment, suggesting iris ciliary body and choroid melanoma. Due to the bad prognosis of the affected eye, the patient underwent to Orbital Exenteration procedure. The extracted eyeball was placed in 10% formalin and sent for histopathological examination, which was later reported as showing an iris melanoma involving the ciliary body and the choroid coat. The patient was re-examined six months postoperatively and no neoplasm recurrence signs were observed. Discussion: The animal stated in this report showed an increased volume of the right eye and dark pigmentation involving the iris. As highlighted by the actual literature, the size of this kind of neoplasm can vary from small to larger nodules and it can causes relevant anatomical changes. The pigmentation in these cases may vary from dark colors (black or brown) to white, for example, the amelanotic melanomas. In this report it was observed a nodular staining quite blackened pigmentation. This kind of cancer involves mainly not neutered male dogs, with breed predilection as the German shepherd dogs, Golden Retrievers, Labrador Retrievers and also Poodles, as reported in this case. The treatment suggested by the literature, can range from diode laser therapy to microsurgical resection with enucleation or Exenteration, depending on the size of the affected region and structures involved. The treatment of choice in this patient was the Orbital Exenteration because of the capacity of this tumor to spread throughout the uvea and it was not sure whether scleral infiltration could already exist, although the enucleation could also be indicated. However, through the histopathological examination, it could be confirmed that the neoplasm was located only at iris, involving also the ciliary body and choroid coat without sclera leakage, so there would be no need for Exenteration. The average age of the patients is around nine years old according to published reports, namely older animals as the patient here described. The Orbital Exenteration technique, with good safety margin resection, proved to be efficient for the surgical treatment of iris melanoma involving the ciliary body
Ney Luis Pippi - One of the best experts on this subject based on the ideXlab platform.
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melanoma of the iris ciliary body and choroid in a dog s poodle
Acta Scientiae Veterinariae, 2016Co-Authors: Luis Felipe Dutra Correa, Rafael Oliveira Chaves, Marilia Teresa De Oliveira, J P S Feranti, Bruna Copat, Dakir Polidoro Neto, Ney Luis PippiAbstract:Background : Melanoma is a primary ocular neoplasm that may affect the iris, ciliary body, the choroid coat and others components of the eye. The ocular melanomas have a low metastatic level in dogs when compared to cats. Old animals are more affected than the young ones and there is no breed predilection. A complete eye examination and ocular ultrasound will lead to the diagnosis that will be further confirmed through histopathology. Current treatment of choice is based on the size and the structures involved by the tumor that can range from local resection to Orbital Exenteration. The objective of this study is to report a case of iris melanoma involving the ciliary body and the choroid coat of a Poodle, emphasizing its clinical manifestation, diagnosis and treatment. Case : This study reports a case of an intact male canine Poodle, 15 years old, weighing 5 kg that was referred for care to the Veterinary Teaching Hospital of the Federal University of Santa Maria, Brazil. The owner initially presented a history of a progressive increase dark-colored intraocular volume in the right eye iris of the dog. On the clinical examination, no abnormality was found. On the ophthalmic examination, the right eye possessed misshapen pupil, hyperemia ocular conjunctiva (+) and diffuse corneal opacity (+) with paracentral pigmentation between 7-10 hour. On biomicroscopic examination, using a slit lamp, it was observed an iris distension that was protruding directly into the anterior chamber and a diffuse opacity of the lens. Intraocular pressure was eight mmHg. B-mode ultrasonography revealed a mass involving the iris, ciliary body and the choroid coat with perilesional retinal detachment, suggesting iris ciliary body and choroid melanoma. Due to the bad prognosis of the affected eye, the patient underwent to Orbital Exenteration procedure. The extracted eyeball was placed in 10% formalin and sent for histopathological examination, which was later reported as showing an iris melanoma involving the ciliary body and the choroid coat. The patient was re-examined six months postoperatively and no neoplasm recurrence signs were observed. Discussion : The animal stated in this report showed an increased volume of the right eye and dark pigmentation involving the iris. As highlighted by the actual literature, the size of this kind of neoplasm can vary from small to larger nodules and it can causes relevant anatomical changes. The pigmentation in these cases may vary from dark colors (black or brown) to white, for example, the amelanotic melanomas. In this report it was observed a nodular staining quite blackened pigmentation. This kind of cancer involves mainly not neutered male dogs, with breed predilection as the German shepherd dogs, Golden Retrievers, Labrador Retrievers and also Poodles, as reported in this case. The treatment suggested by the literature, can range from diode laser therapy to microsurgical resection with enucleation or Exenteration, depending on the size of the affected region and structures involved. The treatment of choice in this patient was the Orbital Exenteration because of the capacity of this tumor to spread throughout the uvea and it was not sure whether scleral infiltration could already exist, although the enucleation could also be indicated. However, through the histopathological examination, it could be confirmed that the neoplasm was located only at iris, involving also the ciliary body and choroid coat without sclera leakage, so there would be no need for Exenteration. The average age of the patients is around nine years old according to published reports, namely older animals as the patient here described. The Orbital Exenteration technique, with good safety margin resection, proved to be efficient for the surgical treatment of iris melanoma involving the ciliary body and the choroid coat. Keywords: ophthalmology, neoplasm, uvea.
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melanoma de iris corpo ciliar e coroide em um cao da raca poodle
Acta Scientiae Veterinariae, 2016Co-Authors: Luis Felipe Dutra Correa, Rafael Oliveira Chaves, Marilia Teresa De Oliveira, J P S Feranti, Bruna Copat, Dakir Polidoro Neto, Ney Luis Pippi, Mauricio Veloso BrunAbstract:Background: Melanoma is a primary ocular neoplasm that may affect the iris, ciliary body, the choroid coat and others components of the eye. The ocular melanomas have a low metastatic level in dogs when compared to cats. Old animals are more affected than the young ones and there is no breed predilection. A complete eye examination and ocular ultrasound will lead to the diagnosis that will be further confirmed through histopathology. Current treatment of choice is based on the size and the structures involved by the tumor that can range from local resection to Orbital Exenteration. The objective of this study is to report a case of iris melanoma involving the ciliary body and the choroid coat of a Poodle, emphasizing its clinical manifestation, diagnosis and treatment. Case: This study reports a case of an intact male canine Poodle, 15 years old, weighing 5 kg that was referred for care to the Veterinary Teaching Hospital of the Federal University of Santa Maria, Brazil. The owner initially presented a history of a progressive increase dark-colored intraocular volume in the right eye iris of the dog. On the clinical examination, no abnormality was found. On the ophthalmic examination, the right eye possessed misshapen pupil, hyperemia ocular conjunctiva (+) and diffuse corneal opacity (+) with paracentral pigmentation between 7-10 hour. On biomicroscopic examination, using a slit lamp, it was observed an iris distension that was protruding directly into the anterior chamber and a diffuse opacity of the lens. Intraocular pressure was eight mmHg. B-mode ultrasonography revealed a mass involving the iris, ciliary body and the choroid coat with perilesional retinal detachment, suggesting iris ciliary body and choroid melanoma. Due to the bad prognosis of the affected eye, the patient underwent to Orbital Exenteration procedure. The extracted eyeball was placed in 10% formalin and sent for histopathological examination, which was later reported as showing an iris melanoma involving the ciliary body and the choroid coat. The patient was re-examined six months postoperatively and no neoplasm recurrence signs were observed. Discussion: The animal stated in this report showed an increased volume of the right eye and dark pigmentation involving the iris. As highlighted by the actual literature, the size of this kind of neoplasm can vary from small to larger nodules and it can causes relevant anatomical changes. The pigmentation in these cases may vary from dark colors (black or brown) to white, for example, the amelanotic melanomas. In this report it was observed a nodular staining quite blackened pigmentation. This kind of cancer involves mainly not neutered male dogs, with breed predilection as the German shepherd dogs, Golden Retrievers, Labrador Retrievers and also Poodles, as reported in this case. The treatment suggested by the literature, can range from diode laser therapy to microsurgical resection with enucleation or Exenteration, depending on the size of the affected region and structures involved. The treatment of choice in this patient was the Orbital Exenteration because of the capacity of this tumor to spread throughout the uvea and it was not sure whether scleral infiltration could already exist, although the enucleation could also be indicated. However, through the histopathological examination, it could be confirmed that the neoplasm was located only at iris, involving also the ciliary body and choroid coat without sclera leakage, so there would be no need for Exenteration. The average age of the patients is around nine years old according to published reports, namely older animals as the patient here described. The Orbital Exenteration technique, with good safety margin resection, proved to be efficient for the surgical treatment of iris melanoma involving the ciliary body and the choroid coat.
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melanoma de iris corpo ciliar e coroide em um cao da raca poodle melanoma of the iris ciliary body and choroid in a dog s poodle
2016Co-Authors: Luis Felipe Dutra Correa, Rafael Oliveira Chaves, Marilia Teresa De Oliveira, J P S Feranti, Bruna Copat, Ney Luis Pippi, Dakir Nilton, Polidoro Neto, Mauricio Veloso BrunAbstract:Background: Melanoma is a primary ocular neoplasm that may affect the iris, ciliary body, the choroid coat and others components of the eye. The ocular melanomas have a low metastatic level in dogs when compared to cats. Old animals are more affected than the young ones and there is no breed predilection. A complete eye examination and ocular ultrasound will lead to the diagnosis that will be further confirmed through histopathology. Current treatment of choice is based on the size and the structures involved by the tumor that can range from local resection to Orbital Exenteration. The objective of this study is to report a case of iris melanoma involving the ciliary body and the choroid coat of a Poodle, emphasizing its clinical manifestation, diagnosis and treatment. Case: This study reports a case of an intact male canine Poodle, 15 years old, weighing 5 kg that was referred for care to the Veterinary Teaching Hospital of the Federal University of Santa Maria, Brazil. The owner initially presented a history of a progressive increase dark-colored intraocular volume in the right eye iris of the dog. On the clinical examination, no abnormality was found. On the ophthalmic examination, the right eye possessed misshapen pupil, hyperemia ocular conjunctiva (+) and diffuse corneal opacity (+) with paracentral pigmentation between 7-10 hour. On biomicroscopic examination, using a slit lamp, it was observed an iris distension that was protruding directly into the anterior chamber and a diffuse opacity of the lens. Intraocular pressure was eight mmHg. B-mode ultrasonography revealed a mass involving the iris, ciliary body and the choroid coat with perilesional retinal detachment, suggesting iris ciliary body and choroid melanoma. Due to the bad prognosis of the affected eye, the patient underwent to Orbital Exenteration procedure. The extracted eyeball was placed in 10% formalin and sent for histopathological examination, which was later reported as showing an iris melanoma involving the ciliary body and the choroid coat. The patient was re-examined six months postoperatively and no neoplasm recurrence signs were observed. Discussion: The animal stated in this report showed an increased volume of the right eye and dark pigmentation involving the iris. As highlighted by the actual literature, the size of this kind of neoplasm can vary from small to larger nodules and it can causes relevant anatomical changes. The pigmentation in these cases may vary from dark colors (black or brown) to white, for example, the amelanotic melanomas. In this report it was observed a nodular staining quite blackened pigmentation. This kind of cancer involves mainly not neutered male dogs, with breed predilection as the German shepherd dogs, Golden Retrievers, Labrador Retrievers and also Poodles, as reported in this case. The treatment suggested by the literature, can range from diode laser therapy to microsurgical resection with enucleation or Exenteration, depending on the size of the affected region and structures involved. The treatment of choice in this patient was the Orbital Exenteration because of the capacity of this tumor to spread throughout the uvea and it was not sure whether scleral infiltration could already exist, although the enucleation could also be indicated. However, through the histopathological examination, it could be confirmed that the neoplasm was located only at iris, involving also the ciliary body and choroid coat without sclera leakage, so there would be no need for Exenteration. The average age of the patients is around nine years old according to published reports, namely older animals as the patient here described. The Orbital Exenteration technique, with good safety margin resection, proved to be efficient for the surgical treatment of iris melanoma involving the ciliary body