title: Histopathologic characteristics of choroidal melanoma in eyes enucleated after iodine 125 brachytherapy in the collaborative ocular melanoma study.
abstract: OBJECTIVE
  To describe the histopathologic findings in eyes with uveal melanoma that had secondary enucleation after failed brachytherapy plaque treatment.
  
  
  METHODS
  Histopathologic findings in eyes that had secondary enucleation after plaque radiation therapy in the Collaborative Ocular Melanoma Study (COMS) were reported on a standardized data form. The findings were compared with eyes that had primary enucleation for uveal melanoma.
  
  
  RESULTS
  Seventy-five eyes that had secondary enucleation were studied. Compared with primary enucleations, tumors in the irradiated eyes had lower mitotic activity, a smaller proportion of histologically intact tumor, more inflammation, more fibrosis, and more vascular damage within the tumor. In addition, compared with primary enucleations, eyes previously irradiated had a higher frequency of retinal invasion by the tumor and greater damage to the retinal vasculature, consistent with radiation retinopathy; neovascularization of the iris; and vitreous hemorrhage. Tumor growth or extrascleral extension was confirmed histopathologically in 25 of 42 eyes (60%) enucleated because of a reported failure of local control.
  
  
  CONCLUSIONS
  Eyes with secondary enucleation after brachytherapy differ histopathologically from eyes with primary enucleation for uveal melanoma. These histopathologic differences may be due to the effects of radiation, tissue conditions related to plaque failure, and, in some cases, tumor growth. In 40% of eyes enucleated because of suspected failure of local control, increased tumor size could not be histologically confirmed.
authors.affiliation: Division of Ophthalmology, University of New Mexico, Albuquerque, USA.
authors.forename: Robert B
authors.initials: RB
authors.lastname: Avery
authors.forename: Marie
authors.initials: M
authors.lastname: Diener-West
authors.forename: Sandra M
authors.initials: SM
authors.lastname: Reynolds
authors.forename: Hans E
authors.initials: HE
authors.lastname: Grossniklaus
authors.forename: W Richard
authors.initials: WR
authors.lastname: Green
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Albert
mesh_terms: D001918:Brachytherapy / Q000379:methods*; D002830:Choroid Neoplasms / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D015353:Eye Enucleation; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D007498:Iris / Q000098:blood supply; D008545:Melanoma / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D009361:Neoplasm Invasiveness; D009389:Neovascularization, Pathologic / Q000175:diagnosis; D011832:Radiation Injuries / Q000209:etiology / Q000473:pathology; D012160:Retina / Q000473:pathology / Q000528:radiation effects; D017211:Treatment Failure; D014823:Vitreous Hemorrhage / Q000209:etiology / Q000473:pathology
chemical_list: D007457:Iodine Radioisotopes