Evisceration and ocular tumors: What are the consequences?

Lemaître, S.; Lévy-Gabriel, Christine; Réyès, Cécile; Desjardins, Laurence; Gentien, David; Zmuda, Mathieu; Jacomet, P.V.; Rouic, Livia Lumbroso‐Le; Dendale, R.; Vincent‐Salomon, Anne; Pierron, Gaëlle; Galatoire, O.; Cassoux, Nathalie

doi:10.1016/j.jfo.2016.10.007

Cited by 9 publications

(8 citation statements)

References 26 publications

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“…Adenocarcinoma associated with CHRPE is variably managed with local resection [14,15], enucleation [16], and proton-beam therapy followed by local excision [17]. RPE tumours have been reported to arise from RPE hyperplasia, in the setting of post-inflammatory scars [2,19,24], scarred choroidal neovascular membrane (CNVM) [10], and painful blind eyes [5,7,8,[25][26][27]. All these conditions have one common denominator, the abnormal proliferation of the RPE incited by various stimuli.…”

Section: Presenting Symptomsmentioning

confidence: 99%

“…The patient died 14 months after enucleation due to pulmonary embolism, despite palliative craniospinal radiation. Lemaître et al [25] reported a case of unsuspected pigment epithelium adenocarcinoma with the dissemination of tumour cells in the orbit following evisceration, with local progression to the brain and the death of the patient. Systemic metastatic workup was negative in this patient.…”

Section: Clinical Course and Prognosismentioning

confidence: 99%

“…Unfortunately, MRI may not differentiate RPE tumours from other tumours such as malignant melanoma or choroidal haemangioma since the imaging properties are similar [38]. MRI is done to rule out orbital extension and the rare possibility of intracranial metastases through local progression [8, 21, 25, 26].…”

Section: Literature Reviewmentioning

confidence: 99%

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Retinal Pigment Epithelium Adenoma and Adenocarcinoma: A Review

et al. 2020

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Adenoma and adenocarcinoma of the retinal pigment epithelium (RPE) are rare intraocular tumours that are often misdiagnosed as posterior uveal melanoma or other simulating lesions. It is important to be able to differentiate these tumours from melanoma for 3 reasons. First, an inability to rule out melanoma often tilts the management towards enucleation. Second, management options like radiotherapy and local resection which work well for melanoma may not be easily applied to these tumours. Third, and most importantly, patients with melanoma need a lifetime follow-up to rule out metastases (metastatic dormancy) whereas RPE tumours hardly metastasize. An abruptly elevated, often deeply pigmented tumour, with a prominent retinal feeding artery and a draining vein causing exudation, should raise a suspicion of RPE tumours. RPE tumours have a remarkable local invasive potential but a low metastatic potential. Most RPE tumours require treatment due to local complications. Small, asymptomatic tumours can be generally observed. Enucleation is still the gold standard of treatment, although local resection has been reported in selected cases with good results. Here, we provide a comprehensive review of the demographic, clinical, and imaging features of true acquired neoplasms of the RPE, namely adenoma and adenocarcinoma, the ways to differentiate them from melanoma, their clinical course and prognosis, and Options for their management.

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Section: Presenting Symptomsmentioning

confidence: 99%

Section: Clinical Course and Prognosismentioning

confidence: 99%

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Retinal Pigment Epithelium Adenoma and Adenocarcinoma: A Review

et al. 2020

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“…Eagle et al [14] reported 7 cases of uveal melanoma detected on evisceration and commented on tumour necrosis mimicking endophthalmitis. Preoperative B-scan as a minimum prior to evisceration surgery for painful blind eyes is always suggested, but because of the fact that preoperative imaging is not always successful for diagnosing a possible intraocular malignancy, the evisceration specimen should always be sent for histological analysis to exclude malignancy, in order to perform prompt adjuvant orbital radiotherapy if necessary [12][13][14]. In our case, according to the evisceration surgical notes, it was noted that the sclera had a linear defect.…”

Section: Discussionmentioning

confidence: 82%

“…Evisceration is an established treatment for the management of a painful, blind eye. However, the risk of an ocular tumour having been missed preoperatively could lead to dissemination of tumour cells within the orbit, orbital recurrence, and possible metastasis with subsequent poor prognosis [12]. In a series of 205 eviscerations, Novais et al [13] found tumours in 4 cases representing 1.95% of all eviscerations.…”

Section: Discussionmentioning

confidence: 99%

Aggressive Ciliary Body Adenocarcinoma with Bilateral Lung Metastases: Histological, Molecular, Genetic and Clinical Aspects

et al. 2018

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Purpose of the Study: To describe the clinical and histopathological features of an aggressive ciliary body adenocarcinoma with pulmonary metastases and skull base spread. Procedures and Results: A 45-year-old female patient presented with a post-traumatic phthisical eye that was eviscerated. This showed an unexpected carcinoma (positive for cytokeratins and melanocytic markers), the histological differential diagnosis for which included a primary ciliary body adenocarcinoma or a metastasis. The patient developed rapid post-surgical localized recurrence that required an orbital exenteration. This showed identical tumour to the evisceration specimen, with vascular invasion in orbital blood vessels and a contaminated orbital soft tissue margin. Staging imaging revealed multiple lung metastases, which were biopsied and shown to be a disseminated ciliary body adenocarcinoma rather than a disseminated primary lung carcinoma. The tumour spread locally to the skull base for which radiotherapy was given. Unfortunately, the patient passed away a few weeks later. Conclusions: To our knowledge, this is the first case of ciliary body adenocarcinoma with bilateral lung metastases. The malignant potential of these tumours should be considered as a possibility, and appropriate screening and staging tests should therefore be considered to guide appropriate management.

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2019

Anophthalmia

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Evisceration and ocular tumors: What are the consequences?

Cited by 9 publications

References 26 publications

Retinal Pigment Epithelium Adenoma and Adenocarcinoma: A Review

Retinal Pigment Epithelium Adenoma and Adenocarcinoma: A Review

Aggressive Ciliary Body Adenocarcinoma with Bilateral Lung Metastases: Histological, Molecular, Genetic and Clinical Aspects

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