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TitleEviscerated eyes unexpectedly containing uveal melanoma
Abstract Nr.1046
PurposeTo present two cases with eviscerated eyes containing uveal melanoma and review the literature
MethodsAll the evisceration specimens from a 15 year period were analyzed for malignancies. A literature search on the accidental finding of intraocular malignancy after evisceration was performed
ResultsWe found an incidence of intraocular malignant melanoma of 0.7% (2/315). In these 2 cases, a standard evisceration procedure with implantation of an acrylic ball had been performed for pain in a longstanding blind eye with opaque media. Both patients had a history of glaucoma and massive intraocular hemorrhage, confirmed by repetitive ocular ultrasound, and in one patient by an additional orbital CT scan. Histopathology showed a large intraocular uveal melanoma with substantial necrosis and haemorrhage
After negative screening for metastases, an enucleation of the scleral shell and implant was performed. External beam radiation was given to the orbital socket. The first patient died from liver metastases 3 years after the diagnosis, without evidence of local recurrence. The second patient has a too short a follow-up
The literature is scarce on this subject, with only 9 published cases. Ultrasound is the mainstay in the screening for intraocular tumors in opaque eyes. However, there are no guidelines on the management after accidental evisceration of an intraocular malignancy
ConclusionOcular ultrasound can not always distinguish primary choroidal hemorrhage from secondary hemorrhage due to uveal melanoma with necrosis. An atypical clinical history of a blind painful opaque eye with prolonged massive intraocular hemorrhage and ocular hypertension may be suspect for malignant melanoma, in which case evisceration should be avoided
Authors 1
Last nameVAN GINDERDEUREN
InitialsR
DepartmentOogziekten
CityLeuven
Authors 2
Last nameMombaerts
InitialsI
DepartmentOogziekten
CityLeuven
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