Clinicopathologic findings in recurrent choroidal melanoma after transpupillary thermotherapy.
OBJECTIVE
This study aimed to report the clinicopathologic findings of recurrent choroidal melanoma after transpupillary thermotherapy (TTT).


METHODS
Two case reports.


METHODS
The clinical histories and ophthalmologic findings of two patients with recurrent choroidal melanomas who did not respond to TTT were reviewed. Both patients had their eyes with the melanoma enucleated and processed routinely for light and electron microscopic examination.


METHODS
The eyes were examined for histopathologic and ultrastructural findings.


RESULTS
Histopathologic examination showed choroidal melanomas with extensive tumor necrosis and hemorrhage. In areas, tumor cells appeared histologically intact and presumably viable, with ultrastructural evidence of melanogenesis. The eye from one patient was treated only with TTT and showed hemorrhagic necrosis with cytolysis and no changes to tissues surrounding the melanoma. The eye from the other patient, treated with TTT and a radioactive isotope of iodine (I125) plaque, exhibited areas of intact tumor, tumor necrosis, fibrosis, and radiation retinopathy.


CONCLUSIONS
These two cases among a total treated series of 14 patients represent examples of uveal melanoma regrowth after TTT. Opaque media precluded adequate treatment in the first case that showed some TTT effect. The second case showed a combination of TTT and I125 effect and failed because of the aggressive nature of tumor.
Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA.
C E
CE
Diaz
A
A
Capone
H E
HE
Grossniklaus
D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects; D002830:Choroid Neoplasms / Q000209:etiology / Q000473:pathology* / Q000628:therapy; D015353:Eye Enucleation; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced / Q000009:adverse effects; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D053685:Laser Therapy; D008297:Male; D008545:Melanoma / Q000209:etiology / Q000473:pathology* / Q000628:therapy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology / Q000473:pathology* / Q000628:therapy; D011680:Pupil; D011832:Radiation Injuries / Q000209:etiology / Q000473:pathology; D012160:Retina / Q000473:pathology / Q000528:radiation effects
D007457:Iodine Radioisotopes