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Adult Ocular and Orbital (Ocular Adnexa) Tumors
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
P.N. Plowman, Rachel Lewis, J.L. Hungerford
Malignant tumors of the uveal tract are predominantly malignant melanomas. Uveal melanoma is the most common of all primary intra-ocular tumors. The neoplasm is most commonly encountered in the choroid but also arises in the ciliary body and occasionally in the iris. This tumor was formerly managed by enucleation of the eye. The survival rate following enucleation has been shown to be dependent on the size of the tumor, histological cell type, tumor’s position within the eye, presence or absence of extra-scleral extension, and age of the patient. Large melanomas, ciliary-body melanomas, and melanomas containing epithelioid cells or extending extra-sclerally have a relatively bad prognosis, particularly in the elderly. For large tumors, the overall mortality rate approaches 50%, and classically the mean interval reported from treatment to the development of metastases is 43 months. Metastases are rarely detectable at the time of diagnosis of the ocular primary.
Melanomas
Published in E. George Elias, CRC Handbook of Surgical Oncology, 2020
Small conjunctival melanomas can be treated by excision. However, further extension on the bulbar surface, conjunctival fornix, and the palpebral and corneal surfaces will require enucleation of the eye. The prognosis depends on the extent of the disease and the initial surgical approach.
Oncology
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
Gill A. Levitt, Penelope Brock, Tanzina Chowdhury, Mark Gaze, Darren Hargrave, Judith Kingston, Antony Michalski, Olga Slater
Treatment of intraocular tumours is dependent on tumour size and location. Focal therapies, laser therapy and cryotherapy are used for small localised tumours. Enucleation of the eye is the treatment of choice for E eyes and the most common treatment for unilateral disease, with 80% of unilateral children undergoing primary surgery. Children with bilateral tumours usually receive primary chemotherapy with focal consolidation therapies as indicated.
Risk factors for enucleation or evisceration in endophthalmitis
Published in Orbit, 2023
Meleha Ahmad, Rupin Parikh, Anam Akhlaq, Tejus Pradeep, Mark P. Breazzano, Roxana Fu
Statistical analysis was done using SPSS version 25.0 (IBM Corp., Armonk, NY). Overall, patients were divided into two groups: those who needed eye-removal surgery (evisceration or enucleation) and those who were managed without enucleation or evisceration (eye sparing therapy group). Normality of the data was assessed using Kolmogorov – Smirnov test. All the parameters were expressed as mean ± standard error of the mean (SEM). Analysis of variance (ANOVA), Chi-squared test (for non-parametric variables) and Student’s t-tests (for parametric variables) were used to assess differences between the two groups. Additionally, odds ratios were calculated to identify factors associated with enucleation or evisceration and multivariate analysis was performed to adjust for confounders. Using a confidence interval of 95%, a p-value of <.05 was considered statistically significant. Characteristics of patients receiving enucleation versus evisceration were compared using non-parametric tests.
A case of primary orbital solitary fibrous tumor with lung metastases 41 years after initial treatment
Published in Orbit, 2022
Mika Tanabe, Hiroshi Yoshikawa, Yuichi Yamada, Yoshinao Oda, Koh-Hei Sonoda
Surgery was performed the following month. Intra-operative palpation revealed a tumor about the size of an egg (approximately 3–4 cm), extending from below the globe to the posterior portion of the cone of the orbit. During enucleation of the eye, the tumor was found to be hard, and its position was confirmed. The tumor was detached from the floor of the orbit, followed by complete removal via exenteration. No adhesion to the optic nerve was observed. There was residual soft tissue, including adipose tissue, deep within the orbit. On histopathological examination of the excised tissue, antler-like blood vessels, and proliferating spindle-shaped cells in the perivascular region were observed, leading to the diagnosis of hemangiopericytoma (HPC; Figure 1), according to the criteria at that time. However, retrospectively, the tumor fits the current definition of an SFT (refer to the discussion below).
Simultaneous identification of clinically relevant RB1 mutations and copy number alterations in aqueous humor of retinoblastoma eyes
Published in Ophthalmic Genetics, 2020
Liya Xu, Lishuang Shen, Ashley Polski, Rishvanth K. Prabakar, Rachana Shah, Rima Jubran, Jonathan W. Kim, Jacklyn Biegel, Peter Kuhn, David Cobrinik, James Hicks, Xiaowu Gai, Jesse L. Berry
A clear corneal paracentesis with a 32-gauge needle was performed to extract 0.1 mL of AH from retinoblastoma eyes (18). This procedure occurred either as part of the standard intravitreal melphalan (IVM) injection protocol (20), immediately following enucleation of the eye, or at diagnosis after diagnostic examination under anesthesia. During sampling, needles entered only the anterior chamber via the clear cornea and remained bevel up over the pharmacologically dilated iris; they did not make contact with the iris, lens, vitreous cavity or tumor. While the anterior chamber shallowed slightly it remained formed during paracentesis, and the needle site was examined after AH extraction for any leakage. No patient had a complication from the extraction.