Solid iridociliary carcinoma in a dog

Background: Iridociliary epithelial tumors (ICETs) originate from the iris epithelium or ciliary body. They comprise ciliary body adenoma, carcinoma, pleomorphic adenocarcinomas, medulloepitheliomas, and other primitive neuroectodermal tumors. They are the second most common primary intraocular tumors in dogs and have already been reported in sheep and humans. In dogs, they occur more frequently in middle-aged to elderly animals, and the Labrador and Golden Retriever seem to be more predisposed breeds. This study aimed to describe the clinical and pathological aspects of solid iridociliary carcinoma in a dog. Case: A 3-year-old Poodle bitch was treated for discomfort in the left eyeball region, increased intraocular pressure and moderate buphthalmia. A direct ophthalmological examination was performed without equipment, and a mass was visualized in the posterior chamber, distorting the pupillary cleft. We opted for unilateral enucleation and forwarded the material for histological analysis. Macroscopically, the eyeball measured 3.4 cm (anteroposterior) x 2.6 cm (vertical), with a brownish mass that occupied the entire anterior chamber and part of the posterior chamber. Histologically, there was a neoformation in the ciliary body and iris pigment epithelium, partially well-delimited and densely cellular. The neoplasm was organized into predominantly solid formations interspersed with a discrete amount of blood vessels, rare bundles of fibrous stroma, and amorphous eosinophilic material forming membranes that were positive for PAS. Sections of the neoplasm were subjected to immunohistochemistry using anti-cytokeratin AE1/AE3, anti-S100 protein, anti-vimentin, and anti-Ki-67. Positive cytoplasmic immunostaining for cytokeratin and S-100 was observed. Only 45.6% of cells were positive for Ki-67 (500 cells). No immunostaining was observed for vimentin. Discussion: The diagnosis of solid iridociliary carcinoma was based on the histological features and positive immunostaining for cytokeratin AE1/AE3 and protein S100. Iridociliary carcinomas present positive immunostaining for cytokeratin, whereas adenomas and normal iridociliary epithelium do not present this immunostaining. Moreover, the high rate of cell proliferation was indicative of malignant neoplasia, as observed by the high mitotic count and high positivity for Ki-67. The S100 protein helped in the diagnosis of ICETs, as the iridociliary epithelium showed positive staining for this protein. Some histological features are important to consider in the diagnosis of iridociliary tumors in dogs, such as noninvasive growth in the posterior chamber, pigment epithelium, and thick homogeneous membranes on the cell surface. Furthermore, the presence of positive PAS membranes favors the diagnosis of iridociliary epithelial tumors. ICETs must be differentiated from melanocytomas, anterior uveal melanoma, medulloepitheliomas, and metastatic and pleomorphic carcinomas. The histological characteristics, especially the presence of PAS-positive membranes, associated with the immunohistochemical profile of neoplasm cells, help differentiate the ICETs from these tumors. In general, the prognosis is poor for eyeball and vision maintenance in canine iridociliary tumors, and scleral invasion is associated with a higher recurrence rate.

Spontaneous microscopic hyphema secondary to iris vascular tufts: Case report with video documentation.

A 71-year-old woman presented with spontaneous microhyphema in her left eye, causing blurry vision. Bleeding stopped spontaneously shortly after several cycles of digital compression on the upper eyelid, (which were documented in video), and therefore, did not require laser photocoagulation, a possible approach previously explained to the patient. A microhemangioma at the edge of the iris was identified to be the cause of the condition. The hemorrhage did not recur during the follow-up period (9 months).

Amelanotic iris melanoma in a 7 year-old hispanic boy with subclinical globe perforation. / Melanoma amelanótico del iris en un niño hispano de 7 años con perforación del globo subclínica.

We report an unusual case of an amelanotic melanoma in a 7 year old hispanic child with subclinical globe perforation. Uveal melanoma rarely occurs in children. Young affected patients are mostly light-colored eye Caucasian adolescents. Since they are not common, these tumors are usually not recognized and misdiagnosed. Differential diagnoses and therapeutic options are outlined.

Symptomatic primary iris cysts treated with frequency-doubled Nd: YAG laser photocoagulation / Cistos irianos primários sintomáticos tratados com fotocoagulação a laser de Nd: YAG de dupla frequência

Abstract We report the case of a 31-year-old woman who presented with a nine-month history of blurred vision in her left eye. Slit-lamp examination and optical coherence tomography showed four cystic masses hanging at the pupillary margin of the left eye. Neodymium:Yttrium-Aluminum-Garnet (Nd:YAG) laser photocoagulation was used to rupture the wall (cystotomy), drain the cyst content and shrink the remnants of the pigment epithelium, using laser parameters at the lowest effective levels. The patient's best corrected visual acuity improved significantly after treatment. Despite the increase of pigment at anterior chamber angle, no complication was observed during 6 months of follow up. This is the first report to describe frequency-doubled Nd:YAG laser (532 nm) photocoagulation as a therapeutic option for patients with symptomatic primary IPE cysts at pupillary margin.

Resumo Relatamos o caso de uma mulher de 31 anos com queixa de visão turva no olho esquerdo. Exame em lâmpada de fenda e tomografia de coerência óptica mostraram quatro lesões císticas nas margens da pupila esquerda. O laser do tipo Neodymium:Yttrium-Aluminum-Garnet (Nd:YAG) de dupla-frequência foi o tratamento de escolha para romper a parede (cistotomia), drenar o conteúdo do cisto e encolher os remanescentes do epitélio de pigmentar utilizando os menores parâmetros efetivos. Após o tratamento do olho comprometido, sua acuidade visual melhorou consideravelmente. Apesar do aumento da pigmentação no ângulo da câmara anterior, nenhuma complicação foi observada durante 6 meses de acompanhamento. Este é o primeiro relato que descreve o laser de Nd:YAG de dupla frequência (532 nm) como uma opção terapêutica para pacientes com cistos irianos primários do epitélio pigmentar sintomáticos na margem pupilar.

Iris metastases from systemic cancer: a report of three cases / Metástase de íris de câncer sistêmico: relato de três casos

ABSTRACT Ocular metastasis is relatively uncommon, with a reported incidence of approximately 8%, according to the results of autopsy evaluation. The majority of ocular metastases are located within the choroid, while metastatic tumors affecting the iris are rare. Metastatic tumors may manifest as stromal nodules or ill-defined iris thickening, or they may present with nonspecific features such as pain, iridocyclitis, and hyphema. Here, we describe three patients with iris metastasis and discuss the diagnostic challenges and unusual findings associated with these cases.

RESUMO A maioria das metástases oculares do câncer sistêmico são encontrados na coroide. As metástases para a íris são incomuns, podendo se manifestar como nódulo estromal, espessamento de íris de limites mal definidos ou como uma iridociclite ou hifema. Relatamos 3 pacientes com lesão de íris e história pregressa de câncer sistêmico. Enfatizamos a dificuldade no diagnóstico e raridade dessas lesões comparando com relatos anteriores.

Iris metastases from systemic cancer: a report of three cases.

Ocular metastasis is relatively uncommon, with a reported incidence of approximately 8%, according to the results of autopsy evaluation. The majority of ocular metastases are located within the choroid, while metastatic tumors affecting the iris are rare. Metastatic tumors may manifest as stromal nodules or ill-defined iris thickening, or they may present with nonspecific features such as pain, iridocyclitis, and hyphema. Here, we describe three patients with iris metastasis and discuss the diagnostic challenges and unusual findings associated with these cases.

Melanoma of the iris, ciliary body and choroid in a dog's Poodle / Melanoma de íris, corpo ciliar e coroide em um cão da raça Poodle

Background: Melanoma is a primary ocular neoplasm that may affect the iris, ciliary body, the choroid coat and others components of the eye. The ocular melanomas have a low metastatic level in dogs when compared to cats. Old animals are more affected than the young ones and there is no breed predilection. A complete eye examination and ocular ultrasound will lead to the diagnosis that will be further confirmed through histopathology. Current treatment of choice is based on the size and the structures involved by the tumor that can range from local resection to orbital exenteration. The objective of this study is to report a case of iris melanoma involving the ciliary body and the choroid coat of a Poodle, emphasizing its clinical manifestation, diagnosis and treatment. Case: This study reports a case of an intact male canine Poodle, 15 years old, weighing 5 kg that was referred for care to the Veterinary Teaching Hospital of the Federal University of Santa Maria, Brazil. The owner initially presented a history of a progressive increase dark-colored intraocular volume in the right eye iris of the dog. On the clinical examination, no abnormality was found. On the ophthalmic examination, the right eye possessed misshapen pupil, hyperemia ocular conjunctiva (+) and diffuse corneal opacity (+) with paracentral pigmentation between 7-10 hour. On biomicroscopic examination, using a [...]

Melanoma of the iris, ciliary body and choroid in a dog's Poodle / Melanoma de íris, corpo ciliar e coroide em um cão da raça Poodle

Background: Melanoma is a primary ocular neoplasm that may affect the iris, ciliary body, the choroid coat and others components of the eye. The ocular melanomas have a low metastatic level in dogs when compared to cats. Old animals are more affected than the young ones and there is no breed predilection. A complete eye examination and ocular ultrasound will lead to the diagnosis that will be further confirmed through histopathology. Current treatment of choice is based on the size and the structures involved by the tumor that can range from local resection to orbital exenteration. The objective of this study is to report a case of iris melanoma involving the ciliary body and the choroid coat of a Poodle, emphasizing its clinical manifestation, diagnosis and treatment. Case: This study reports a case of an intact male canine Poodle, 15 years old, weighing 5 kg that was referred for care to the Veterinary Teaching Hospital of the Federal University of Santa Maria, Brazil. The owner initially presented a history of a progressive increase dark-colored intraocular volume in the right eye iris of the dog. On the clinical examination, no abnormality was found. On the ophthalmic examination, the right eye possessed misshapen pupil, hyperemia ocular conjunctiva (+) and diffuse corneal opacity (+) with paracentral pigmentation between 7-10 hour. On biomicroscopic examination, using a [...](AU)

Clinical, histologic, and immunohistochemical evaluation of iris metastases from small cell lung carcinoma.

CASE REPORT: We report the case of a patient with small cell lung carcinoma who developed multiple metastases in the iris. The eye was enucleated after failure of a conservative approach. The specimen underwent histologic and immunohistochemical evaluation that confirmed the diagnosis. COMMENTS: Metastatic carcinoma is the most common form of intraocular malignancy, and breast is the most prevalent primary location, followed by lung. Small cell lung carcinoma constitutes 23.1% of lung neoplasias. It has a significantly worse prognosis than non-small cell carcinoma due to its propensity for early and widespread dissemination. Uveal metastases involve the choroid more often than the iris and ciliary body, probably because the arterial distribution is more abundant in the posterior than in the anterior uvea. Iris involvement represents only 9% of the metastatic uveal tumours.

Ultrasound biomicroscopy features of iris and ciliary body melanomas before and after brachytherapy.

BACKGROUND AND OBJECTIVE: To determine ultrasound biomicroscopy (UBM) features of iris and ciliary body melanomas before and after brachytherapy. PATIENTS AND METHODS: Four uveal anterior melanoma cases undergoing brachytherapy were retrospectively studied. All cases were examined by UBM prior to treatment and repeatedly after treatment. RESULTS: Before brachytherapy, UBM examination showed a solid mass in the iris, ciliary body, or both in all four cases and allowed its characterization, sizing, and positioning. Two cases had a pigmented scleral lesion corresponding to the tumor location, but UBM did not detect any scleral infiltration at those sites. After brachytherapy, all lesions showed progressive decrease in size and progressive attenuation of their limits. Internal reflectivity was variable. Complications related to brachytherapy were demonstrated, including cataract, peripheral anterior synechiae at tumor location, and secondary scleral thinning. CONCLUSION: UBM played an important role as a complementary diagnostic method for anterior uveal melanomas, particularly ciliary body melanomas, but also allowed therapeutic planning (brachytherapy or surgery) and follow-up after treatment.

Biomicroscopia ultra-sônica (UBM) no planejamento cirúrgico e acompanhamento pós-operatório de melanomas malignos de íris e corpo ciliar / Ultrasound biomicroscopy (UBM) in the surgical planning and postoperative follow-up of iris and ciliary body melanomas

OBJETIVO: Estudar os achados da biomicroscopia ultra-sônica (UBM) em melanomas malignos primários da íris e corpo ciliar antes e depois da resecçäo cirúrgica e correlacionar a extensäo do tumor (revelado pela biomicroscopia ultra-sônica) aos achados histopatológicos. MÉTODOS: Estudo prospectivo de 5 pacientes com diagnóstico clínico de tumor de íris e/ou corpo ciliar. Estes pacientes foram avaliados pela biomicroscopia ultra-sônica antes e após iridociclectomia ou iridectomia. Os espécimens foram enviados para estudo histopatológico. Os pacientes foram acompanhados por período mínimo de 6 meses quando foi realizada nova biomicroscopia ultra-sônica. RESULTADOS: Neste grupo de 5 pacientes, 3 eram do sexo feminino e 2, do masculino, variaçäo de idade de 32 e 64 anos. Todos os casos eram unilaterais. Quatro pacientes apresentaram massa iridociliar e um apresentou lesäo limitada à íris. Em todos os casos a biomicroscopia ultra-sônica auxiliou o planejamento cirúrgico para a ressecçäo tumoral com margens livres. A biomicroscopia ultra-sônica no pós-operatório revelou ausência de crescimento tumoral em todos os casos, sendo que 2 pacientes apresentaram vítreo na incisäo cirúrgica, 1 deles com traçäo vítrea leve, mas sem sinais de descolamento de retina. CONCLUSÄO: A biomicroscopia ultra-sônica pareceu ser método auxiliar confiável para diagnosticar tumores de íris e corpo ciliar, planejar o tratamento cirúrgico e o acompanhamento pós-operatório

Correlação entre a citologia e a histologia nas lesões intra-oculares suspeitas de malignidade / Cytologic-histologic correlation in intraocular lesions with suspicion of malignancy

OBJETIVO: Correlacionar os achados citológicos da biópsia aspirativa com agulha fina (BAAF) de lesões intra-oculares suspeitas de malignidade com a histopatologia obtida quando o tratamento de escolha foi enucleação ou ressecção da lesão tumoral. MÉTODOS: Análise retrospectiva de 51 pacientes submetidos à biópsia aspirativa com agulha fina com fins diagnósticos ou para correlação cito-histológica. Foram excluídos os casos com lesões não sólidas, tratamento conservador e biópsias guiadas por ultrasom. Após exclusões, 20 olhos de pacientes contendo lesões intra-oculares suspeitas de malignidade foram estudados, sendo 12 do sexo feminino, com idades entre 2 e 78 anos. Todas biópsias foram realizadas pela primeira autora sob observação direta (microscópio) ou indireta (oftalmoscopia binocular indireta). A rota escolhida foi transaquosa para os tumores de segmento anterior e transvítrea com acesso escleral para os tumores de segmento posterior, exceto os casos suspeitos de retinoblastoma, biopsiados com acesso pela periferia da córnea. Foram obtidas 2 amostras de áreas diferentes do tumor em todos os casos com agulha calibre 25. As amostras colhidas foram encaminhadas para processamento, fixação e coloração pelo método de Papanicolaou e hematoxilina-eosina. Os espécimens obtidos para histopatologia foram corados pela hematoxilina-eosina. RESULTADOS: Três casos eram tumores de segmento anterior (íris) e 17 de segmento posterior, sendo 3 retinoblastomas. Nove pacientes foram submetidos à biópsia aspirativa com agulha fina com fins diagnósticos e 11 para correlação cito-histológica após enucleação. Somente dois casos apresentaram quantidade insuficiente de material para diagnóstico e posteriormente revelaram ser um granuloma e um melanoma maligno de coróide. CONCLUSÕES: A biópsia aspirativa com agulha fina parece ser um método diagnóstico confiável baseado na correlação cito-histológica neste grupo de pacientes.

Carcinoma ductal de mama com metástase para íris em paciente com nevus melanocítico da coróide: relato de caso / Metastatic breast cancer to the iris in patient with choroidal melanocitoma: case report

Objetivo: Alertar para a possibilidade do diagnóstico precoce de neoplasias sistêmicas com manifestação metastática ocular. Local: Hospital Geral de Fortaleza/SUS - Laboratório BIOPSE, Fortaleza - CE. Método: Relato de caso de uma paciente de 52 anos com história de mastectomia radical apresentando, 8 meses depois, baixa da acuidade visual e dor ocular intensa. Resultados: O exame oftalmológico evidenciou hiperemia conjuntival moderada, sinéquias posteriores exsudato fibrinóide vindo, posteriormente, à íris, e tumefação no terço externo inferior. A paciente apresentou hipermetropização inicialmente de +1.00D e, posteriormente, de +2.50D no OD, com manutenção da acuidade visual corrigida. Com o seguimento evidenciou-se mudança no aspecto da lesão e aumento da dor, sendo indicada a enucleação. O exame anatomopatológico concluiu tratar-se de carcinoma infiltrante de mama, com metástase para íris e melanocitoma de coróide. Conclusão: Apesar de raro, o carcinoma metastático de íris deve fazer parte do diagnóstico diferencial de afecções oculares em pacientes com neoplasias sistêmicas.

Melanoma de tejido uveal / Uveal melanoma

El melanoma del tracto uveal es el tumor intraocular primario más frecuente en el adulto y se asocia a una alta incidencia de metástasis. Clínicamente puede ser asintomático y descubrirse en el transcurso de una exploración oftalmológica o manifestarse como una masa tumoral que desprende la retina ocasionando pérdida de la función visual. Su diagnóstico se basa en los hallazgos oftalmoscópicos, fluorangiográficos y ecográficos, además de existir pruebas inmunohistoquímicas específicas que determinan su terapéutica en gran medida.La presente sección muestra imágenes ecográficas características de esta patología enfatizando la importancia de este estudio en su diagnóstico.

Estudo do segmento anterior com biomicroscopia ultra-sônica em bloqueio pupilar / Anterior segment study with ultrasound biomicroscopy

Foram estudados quinze pacientes com diagnóstico de ângulo estreito com bloqueio pupilar relativo, através de novo sistema de imagem, a biomicroscopia ultra-sônica de ângulo estreito com bloqueio pupilar relativo. O objetivo do estudo foi medir nestes pacientes o arco de contato írido cristaliniano (ACIC), a abertura do ângulo a 500 (AA500), a distância trabéculo processos ciliares (DTPC) e a espessura da íris periférica (El1); comparar estas medidas ás existentes em pacientes normais e em pacientes com "íris em plateau"; analisar estatisticamente estes dados, para tentar verificar a real importância do arco de contato írido cristaliniano na gênese do bloqueio pupilar relativo e tentar esclarecer outros fatores anatômicos envolvidos na fisiopatologia dos bloqueios pupilares relativos.