title: Evisceration and ocular tumors: What are the consequences?
abstract: OBJECTIVE
  Evisceration can be performed for blind, painful eyes. This surgery can promote the dissemination of tumor cells within the orbit if an ocular tumor has been missed preoperatively.
  
  
  METHODS
  We reviewed the medical records of patients who were eviscerated for blind, painful eyes between 2009 and 2014 and who were referred after the surgery to the Institut Curie or the Rothschild Foundation in Paris. We included the patients with a histological diagnosis of ocular tumor or orbital recurrence. Cytogenetic analysis was performed whenever possible.
  
  
  RESULTS
  Four patients turned out to have an ocular tumor after evisceration (two choroidal melanomas, a rhabdoid tumor and an adenocarcinoma of the retinal pigment epithelium); two had a history of prior ocular trauma. The tumors were diagnosed either on histological analysis of the intraocular contents (2 patients) or biopsy of orbital recurrence (2 patients). Prior to evisceration, fundus examination was not performed in 3 patients. One had preoperative imaging but no intraocular tumor was suspected. At the time of this study, 3 patients had had an orbital recurrence and died. We also found 2 patients who had an evisceration despite a past history of choroidal melanoma treated with proton beam therapy.
  
  
  CONCLUSIONS
  We showed that evisceration of eyes with unsuspected ocular malignancies was associated with a poor prognosis due to orbital recurrence and metastasis. The evisceration specimen should therefore always be sent for histological analysis in order to perform prompt adjuvant orbital radiotherapy if an ocular tumor is found.
authors.affiliation: Institut Curie, 26, rue d'Ulm, 75005 Paris, France; Université Paris Descartes, 12, rue de l'École-de-Médecine, 75270 Paris cedex 06, France. Electronic address: stefaniele@free.fr.
authors.forename: S
authors.initials: S
authors.lastname: Lemaître
authors.affiliation: Fondation ophtalmologique Adolphe de Rothschild, 25-29, rue Manin, 75019 Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Lecler
authors.affiliation: Institut Curie, 26, rue d'Ulm, 75005 Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Lévy-Gabriel
authors.affiliation: Institut Curie, 26, rue d'Ulm, 75005 Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Reyes
authors.affiliation: Institut Curie, 26, rue d'Ulm, 75005 Paris, France.
authors.forename: L
authors.initials: L
authors.lastname: Desjardins
authors.affiliation: Institut Curie, 26, rue d'Ulm, 75005 Paris, France.
authors.forename: D
authors.initials: D
authors.lastname: Gentien
authors.affiliation: Fondation ophtalmologique Adolphe de Rothschild, 25-29, rue Manin, 75019 Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Zmuda
authors.affiliation: Fondation ophtalmologique Adolphe de Rothschild, 25-29, rue Manin, 75019 Paris, France.
authors.forename: P V
authors.initials: PV
authors.lastname: Jacomet
authors.affiliation: Institut Curie, 26, rue d'Ulm, 75005 Paris, France.
authors.forename: L
authors.initials: L
authors.lastname: Lumbroso-Le Rouic
authors.affiliation: Institut Curie, 26, rue d'Ulm, 75005 Paris, France; ICPO centre de protonthérapie, 15, rue Georges-Clemenceau, 91400 Orsay, France.
authors.forename: R
authors.initials: R
authors.lastname: Dendale
authors.affiliation: Institut Curie, 26, rue d'Ulm, 75005 Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Vincent-Salomon
authors.affiliation: Institut Curie, 26, rue d'Ulm, 75005 Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Pierron
authors.affiliation: Fondation ophtalmologique Adolphe de Rothschild, 25-29, rue Manin, 75019 Paris, France.
authors.forename: O
authors.initials: O
authors.lastname: Galatoire
authors.affiliation: Institut Curie, 26, rue d'Ulm, 75005 Paris, France.
authors.forename: N
authors.initials: N
authors.lastname: Cassoux
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery*; D000328:Adult; D000369:Aged, 80 and over; D002830:Choroid Neoplasms / Q000473:pathology / Q000601:surgery; D015353:Eye Enucleation; D017234:Eye Evisceration; D005134:Eye Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D014604:Uveal Neoplasms / Q000473:pathology / Q000601:surgery; D000098943:Uveal Melanoma
keywords: Adenocarcinoma of the retinal pigment epithelium; Adénocarcinome de l’épithélium pigmentaire; Choroidal melanoma; Enucleation; Evisceration; Intraocular tumors; Mélanome choroïdien; Mélanome uvéal; Orbital recurrence; Rhabdoid tumor; Récidive orbitaire; Tumeur oculaire; Tumeur rhabdoïde; Uveal melanoma; Énucléation; Éviscération