Contralateral eyelid metastasis of uveal melanoma with further systemic dissemination.

BACKGROUND: The usual way of dissemination of an uveal malignant melanoma comprises hematogenous metastases to various organs, liver in the first place. Uncommon development of the disease is always possible, while unusual ways of dissemination and secondary deposits in the unexpected sites have been observed. We presented an unusual case of a patient with uveal melanoma metastatic to the contralateral eyelid with very fast further dissemination in the manner typical for primary malignancies. CASE REPORT: This observational case report included a 70-year-old male, enucleated for uveal melanoma in his left eye, appeared again 2.5 years later with a fast growing contralateral eyelid metastasis, followed by submandibular lymph node involvement on the same side and further systemic dissemination. CONCLUSION: The first revealed solitary contralateral eyelid metastasis of uveal melanoma is extremely rare, such as an uncommon secondary deposit with a strange way of further dissemination.

A case of primary peripheral T-cell type non-Hodgkin lymphoma originating in the iris--clinicopathological findings.

BACKGROUND: The ocular adnexal region is the primary localization of extranodal lymphoma in 5% to 15% of all Non-Hodgkin lymphoma. Intraocular lymphoma of T-cell origin is extremely rare and such sites of infiltration have been rarely observed in clinical examination. CASE REPORT: We presented a 56-year-old man with iris infiltration by primary intraocular peripheral T-cell lymphoma. The patient was in clinical stage I BE and the treatment was initiated according to cyclophosphamide, hydroxydaunorubicin, oncovin, prednisone (CHOP) regimen. When the second course of the therapy was scheduled, the patient developed central nervous system lymphoma infiltration. Although De Angelis regimen was used, 3 months after the diagnosis was established, lethal outcome ensued due to disease progression. CONCLUSION: According to our experience we can conclude that further therapeutical approach to patients with primary intraocular T-cell lymphoma requires modification of conventional treatment regimens. The lower median survival in these patients suggests that the disease may be of more aggressive course.

[Comparison of the suppressing capecitabine and 5-fluorouracil effects on the pronounce of inflammatory cells score in the induction of episcleral fibrosis after trabeculectomy].

BACKGROUND/AIM: Trabeculectomy is a filtering antiglaucoma surgery performed to facilitate the formation of a drainage channel for the aqueous humor from the anterior chamber of the eye to the subconjunctival space making a collector, filtering cushion of the eyeliquid. The cause of unfavourable outcome of trabeculectomy is episcleral fibrosis which leads to the obstruction of the drainage channel Inflammatory reaction is an initial, but, also, the key event in the process of fibrosis and directly proportional to it A successful medicamentous suppression of inflammation could stop fibrosis. Arccordingly, the aim of this study was to comparatively evaluate suppressing effects of capecitabine and 5-fluoroaracil upon inflammation, an initial fibrosis process after trabeculectomy. METHODS: This study was performed on an experimental animal model, namely 2 4 rabbits (48 eyes), which were exposed to artificial cause of the tissue changes analogous to human subclinical inflammation. During the trabeculectomy, a 5% solution of 5-fluoroaracil was applied to the right eye sclera of a rabbit, while 2% solution of kapecitabine was applied to the left eye sclera, thus making possible to evaluate the effects of different drugs to the same animal. Two weeks after the surgery the subconjunctival - episcleral tissue cuts were analyzed. Semiquantitative histologic test was used to compare the cellular elements of inflammatory (fibroblasts, mononuclears, plasmocytes, eosinophiles), as well as fibrosing (colagen, reticulin fibers) process, and, based on the differences in histopathologic score, suppressive efficacy of 5-fluoroaracil and kapecitabine was evaluated and compared between the groups of the treated tissues. The results were shown as mean values +/- standard deviation. RESULTS: A statistically significantly lower score was revealed in the initial inflammatory cells - mononudears and plasmocytes in the group of the tissues treated with kapecitabine, while there was no differences between the groups in the score of fibroblasts and colagen fibers. CONCLUSION: The suppression of the initial episcleral fibrosis process obtained by kapecitabine was more significant as compared to the suppression obtained by 5-fluoroaracil, thus providing more favorable outcome of the trabeculectomy.

New RB1 oncogenic mutations and intronic polymorphisms in Serbian retinoblastoma patients: genetic counseling implications.

The purpose of this work was to identify germ line RB1 mutations in 16 Serbian retinoblastoma patients for genetic counselling. Mutation analysis was carried out by PCR directed sequencing of the 27 exons. Loss of heterozygosity for two RB1 intragenic markers was also analyzed in 14 tumour samples. Five new RB1 oncogenic mutations (g.2078 del C, g.77047_48 del GC, g.78117_8 del TT, g.160797 del T, and g.64439+2 T>C) and two recurrences (R445X and Q383X) have been found in this study. In addition, four intronic variants were observed germ line in some unilateral patients. Two of these variants (g.44668-15T/G, and g.166204-8T/A) are discussed as potential oncogenic mutation candidates. The results show the relevance of studies aimed to investigate the role of intronic variants in exon splicing regulation. Such studies will help to disclose hidden retinoblastoma susceptibilities, important for accurate genetic counselling.

[Implantation epithelial iris cyst following the perforating corneal injury].

The objective of this case report was to present the development of implantation cyst following the perforating corneal injury, the problems related to the treatment, including total surgical excision of the cyst, the secondary cataract extraction, iridoplasty and the artificial intraocular lens reposition. A patient first presented with perforating corneal injury inflicted by a piece of wood, with the iris prolapse. Primary wound management, reposition of prolapsed iris and corneal sutures were performed four days after the injury. Eight months later, the patient was rehospitalized due to an implantation iris cyst and traumatic cataract. The cyst was excised, the extracapsular cataract extraction was done and the anterior chamber lens was implanted. Postoperative visual acuity was normal. Three years later, the patient presented for a follow-up examination, with the cyst filled up again, occupying two thirds of the anterior chamber. This time, the cyst was completely excised, all fibrous remnants of the secondary cataract were removed, and the iridoplasty was necessary due to large iris coloboma. Reposition of the anterior chamber lens was carried out. Histological examination revealed an implantation iris cyst covered by multilayered squamous epithelium. Normal visual acuity was achieved. The patient has been followed-up for six months uneventfully. Management of perforating corneal wound with iris prolapse may lead to development of an implantation iris cyst. Puncture of the cyst as well as incomplete excision will not solve the problem. Complete surgical removal of the iris cyst is the treatment of choice.