levoleucovorin and Choroid-Neoplasms

A 59-year-old patient with a coexisting primary choroidal melanoma and colorectal cancer was treated with external beam radiation (EBR) of his choroidal melanoma and systemic chemotherapy with leukovorin/5 fluorouracil (FU) for treatment of his metastatic colorectal cancer. Eight months following EBR, he showed evidence of radiation retinopathy with macular edema. Optical coherence tomography (OCT) showed macular edema and subretinal fluid. Subsequently, systemic bevacizumab (5 mg/kg) was added to his leukovorin/5FU chemotherapy. After the addition of bevacizumab, OCT showed complete resolution of the macular edema and subretinal fluid.. Bevacizumab may have a role in the treatment of radiation retinopathy, but further investigation is needed before any definitive conclusions can be made.

Topics: Adult; Angiogenesis Inhibitors; Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Antimetabolites, Antineoplastic; Bevacizumab; Choroid Neoplasms; Colonic Neoplasms; Colorectal Neoplasms; Fluorouracil; Follow-Up Studies; Humans; Leucovorin; Liver Neoplasms; Macular Edema; Male; Melanoma; Neoplasms, Second Primary; Radiation Injuries; Radiotherapy; Tomography, Optical Coherence; Vascular Endothelial Growth Factor A; Vitamin B Complex

Primary intraocular lymphoma is a distinct subset of primary non-Hodgkin's lymphoma of the CNS. In general, the primary non-Hodgkin's lymphoma of the CNS is rare, accounting for 1 % of all non-Hodgkin's lymphomas and less than 1 % of all intraocular tumors.. A 70-year-old man was hospitalized in June 2002 because of acute loss of vision on his left eye. A severe vitreous hemorrhage was observed. Ultrasound showed solid subretinal lesions at the posterior fundus. Diagnostic vitreous surgery including a biopsy was performed. An intraocular malignant B-cell lymphoma was determined by immunohistochemistry. General screening revealed no further manifestations of the lymphoma.. The patient initially refused any therapy until a painful secondary neovascular glaucoma with complete loss of visual function developed, thus prompting us to perform an enucleation. The following immunohistochemical examination confirmed the initial diagnosis. A chemotherapy with high-dose methotrexate and leucovorin rescue was initiated.. Primary intraocular lymphoma can present as diffuse uveitis refractory to corticosteroids. Diagnosis can be difficult and is often delayed.

Topics: Aged; Biopsy; Blindness; Bruch Membrane; Chemotherapy, Adjuvant; Choroid; Choroid Neoplasms; Combined Modality Therapy; Drug Resistance, Neoplasm; Eye Enucleation; Follow-Up Studies; Humans; Leucovorin; Lymphoma, B-Cell; Male; Methotrexate; Optic Atrophy; Prognosis; Retina; Retinal Neoplasms; Vitrectomy; Vitreous Body; Vitreous Hemorrhage

Topics: Adenocarcinoma; Aged; Antineoplastic Combined Chemotherapy Protocols; Carboplatin; Choroid Neoplasms; Combined Modality Therapy; Esophageal Neoplasms; Fatal Outcome; Fluorescein Angiography; Fluorouracil; Humans; Leucovorin; Male; Middle Aged