phosphorus-radioisotopes and Melanoma

The most common primary ocular tumor in adults is malignant melanoma of the choroid. Metastatic tumors to the choroid occur with the same frequency. The radioactive phosphorous uptake test is used most often as a nuclear diagnostic test. The test does not differentiate melanomas from metastases, and it is necessary to perform surgery for proper placement of a detection device within a distance of 1-2 mm of the tumor. These deficiencies leave ophthalmologists with a pressing need for a gamma-emitting radiopharmaceutical that would facilitate noninvasive identification of choroidal melanoma. This need is made more urgent by the fact that recently, radiation therapy has been used to treat these tumors rather than enucleation. Eyes then harbor irradiated melanoma whose status is unknown. The tumor rarely decreases in size more than 25% to 50%. There is thus a need for a specific diagnostic test to assess the nature of the tumor and the effectiveness of therapy.

Topics: Choroid Neoplasms; Eye Neoplasms; Female; Gallium Radioisotopes; Humans; Iodine Radioisotopes; Melanins; Melanoma; Ophthalmology; Phosphorus Radioisotopes; Radioisotopes; Radiometry; Radionuclide Imaging

Topics: Bleomycin; Chlormerodrin; Eye Neoplasms; Gallium Radioisotopes; Humans; Melanoma; Mercury Radioisotopes; Methods; Orbital Neoplasms; Phosphorus Radioisotopes; Radionuclide Imaging; Selenomethionine; Serum Albumin, Radio-Iodinated; Sodium Pertechnetate Tc 99m; Technetium

Topics: Eye Neoplasms; False Positive Reactions; Humans; Melanoma; Phosphorus Radioisotopes; Radionuclide Imaging

Rapidly proliferating tissue incorporates more phosphorus than normal. Thus, following administration of radioactive phosphorus (32P), tumors emit increased amounts of radiation which can be detected. With the proper test technique, a correct diagnosis rate of 96-100% is quoted in the literature. By comparison, between 4 and 20% of all eyes enucleated for suspected malignant melanoma without prior 32P testing contained no neoplasm histologically. The radiation exposure is minimal due to the short half-life of 32P and the low penetration of beta-particles. However, the test usually involves a small operation (conjunctiva and Tenon incision). Testing with gamma rays, however, is not yet wholly satisfactory due to the lack of a suitable gamma-ray detector.

Topics: Diagnostic Errors; Evaluation Studies as Topic; Eye Neoplasms; False Negative Reactions; False Positive Reactions; Humans; Melanoma; Phosphorus Radioisotopes

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Choroid Neoplasms; Ciliary Body; Eye Diseases; Eye Neoplasms; Female; Hemangioma; Humans; Infant; Infant, Newborn; Iris; Male; Melanoma; Middle Aged; Nevus; Phosphorus Radioisotopes; Pregnancy; Radionuclide Imaging; Retinoblastoma

Topics: Choroid Neoplasms; Diagnosis, Differential; Humans; Melanoma; Neoplasm Metastasis; Nevus, Pigmented; Phosphorus Radioisotopes

Topics: Animals; Cell Survival; Cells, Cultured; Conjunctiva; Dose-Response Relationship, Radiation; Eye Neoplasms; Fast Neutrons; Humans; Hyperbaric Oxygenation; Lentigo; Melanoma; Melanosis; Neoplasm Metastasis; Neoplasms, Experimental; Palliative Care; Phosphorus Radioisotopes; Radiation Effects; Radiotherapy Dosage; Skin Neoplasms

Topics: Administration, Topical; Adolescent; Adult; Aged; Arm; Child; Clinical Trials as Topic; Female; Humans; Iodine Radioisotopes; Leg; Lymph Nodes; Lymphatic Metastasis; Lymphography; Male; Melanoma; Middle Aged; Organophosphorus Compounds; Phosphorus Radioisotopes; Prognosis; Radioisotopes; Radiotherapy Dosage; Skin Neoplasms

In vivo (31) P MRS demonstrates that human melanoma xenografts in immunosuppressed mice treated with lonidamine (LND, 100 mg/kg intraperitoneally) exhibit a decrease in intracellular pH (pH(i) ) from 6.90 ± 0.05 to 6.33 ± 0.10 (p < 0.001), a slight decrease in extracellular pH (pH(e) ) from 7.00 ± 0.04 to 6.80 ± 0.07 (p > 0.05) and a monotonic decline in bioenergetics (nucleoside triphosphate/inorganic phosphate) of 66.8 ± 5.7% (p < 0.001) relative to the baseline level. Both bioenergetics and pH(i) decreases were sustained for at least 3 h following LND treatment. Liver exhibited a transient intracellular acidification by 0.2 ± 0.1 pH units (p > 0.05) at 20 min post-LND, with no significant change in pH(e) and a small transient decrease in bioenergetics (32.9 ± 10.6%, p > 0.05) at 40 min post-LND. No changes in pH(i) or adenosine triphosphate/inorganic phosphate were detected in the brain (pH(i) , bioenergetics; p > 0.1) or skeletal muscle (pH(i) , pH(e) , bioenergetics; p > 0.1) for at least 120 min post-LND. Steady-state tumor lactate monitored by (1) H MRS with a selective multiquantum pulse sequence with Hadamard localization increased approximately three-fold (p = 0.009). Treatment with LND increased the systemic melanoma response to melphalan (LPAM; 7.5 mg/kg intravenously), producing a growth delay of 19.9 ± 2.0 days (tumor doubling time, 6.15 ± 0.31 days; log(10) cell kill, 0.975 ± 0.110; cell kill, 89.4 ± 2.2%) compared with LND alone of 1.1 ± 0.1 days and LPAM alone of 4.0 ± 0.0 days. The study demonstrates that the effects of LND on tumor pH(i) and bioenergetics may sensitize melanoma to pH-dependent therapeutics, such as chemotherapy with alkylating agents or hyperthermia.

Topics: Animals; Antineoplastic Agents, Alkylating; Cell Line, Tumor; Drug Synergism; Energy Metabolism; Hydrogen-Ion Concentration; Indazoles; Magnetic Resonance Spectroscopy; Melanoma; Melphalan; Mice; Phosphorus Radioisotopes; Protons; Treatment Outcome

To evaluate the therapeutic effects of a (32)P-patch in the treatment of a murine melanoma.. Thirty male C57BL6 mice were divided into two groups: treated and control. Superficial tumors were induced in both groups by injecting B16F1 melanoma at about 10 cells/mouse subcutaneously. Tumors developed 10-15 days after transplantation and the (32)P-patch was applied on palpable tumors of the treated group. Tumor growth was followed up in both groups by measuring tumor size with a caliper. After the follow-up period, the animals were killed and tumor samples of the treated and control groups were collected for histological study by preparing paraffin sections stained with hematoxylin-eosin.. The (32)P-patch showed the absence of radioactivity leakage in vitro and the homogeneous distribution of the radionuclide. The skin surface at the application site of the (32)P-patch appeared hairless, and erythema developed, but reversed to normal after a few days in the treated group. Control of tumor growth was achieved in the treated group compared with the control group, although complete remission did not occur.. The (32)P-patch tested for the treatment of a murine melanoma model showed its efficacy, as tumor growth was retarded after application of the patch Nevertheless, adjustment of some therapeutic parameters and/or combining the patch with other treatment modalities may be necessary to achieve complete regression. The P-patch represents a powerful tool to individualize the treatment of melanoma.

Topics: Administration, Topical; Animals; Brachytherapy; Cell Line, Tumor; Dose Fractionation, Radiation; Male; Melanoma; Mice; Phosphorus Radioisotopes; Radioactive Tracers; Skin Neoplasms; Tumor Burden

Radioactive bandages incorporating 32P, a high-energy beta- emitter, were prepared with an aim to have a radiation source that can be used for the treatment of superficial tumors. 32P-Chromic phosphate particles were prepared and filtered through Millipore filters. Filter incorporating 32P activity was immobilized between nitrocellulose membranes and placed on an adhesive bandage. There was no leakage of radioactivity from the bandage when tested in saline. Efficacy of the radioactive bandage for treatment of superficial tumors was tested in melanoma-bearing C57BL/6 mice. A single dose of treatment with 74 MBq 32P bandage resulted in tumor growth delay, whereas multiple dose treatment with 74 MBq 32P bandage at twice-weekly intervals resulted in complete tumor regression when treatment was started, when the tumor was merely palpable. Histology sections from the treated animals showed absence of tumor.

Topics: Administration, Topical; Animals; Bandages; Equipment Design; Melanoma; Melanoma, Experimental; Mice; Mice, Inbred C57BL; Neoplasm Transplantation; Phosphorus Radioisotopes; Radiometry; Skin Neoplasms; Time Factors

To evaluate whether nuclear activity as measured by the disodium phosphate 32P (32P) uptake test for uveal melanoma is of prognostic value and corresponds to known prognostic factors.. A retrospective analysis of 121 patients with choroidal and/or ciliary body melanoma, tested with the 32P uptake test before enucleation between January 1, 1973, and December 31, 1976, at the Leiden University Medical Center. We obtained the 25-year follow-up information of this group of patients and compared the 32P test results and histopathological variables with the long-term survival rates.. The cumulative 5-, 10-, and 20-year survival for melanoma-related death was 81.4%, 73.3%, and 63.9%, respectively. The results of the 32P uptake test were not significantly correlated with survival (P =.35). Of all prognostic factors under study, tumor diameter, cell type, and mitotic count were identified as the most important prognostic markers for uveal melanoma in this group.. The 32P isotope uptake test has no prognostic value for uveal melanoma. Moreover, the results of this study indicate that it is unlikely that cell activity as determined by 32P uptake involves mitotic activity of the tumor.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Diphosphates; Eye Enucleation; Female; Humans; Male; Melanoma; Middle Aged; Phosphorus Radioisotopes; Prognosis; Retrospective Studies; Survival Rate; Uveal Neoplasms

Matrix metalloproteinase-1 (MMP-1, collagenase-1), which degrades interstitial collagen, is expressed at high levels by some tumor cells and is thought to enhance their invasiveness and metastatic potential. We recently described a common single nucleotide insertion polymorphism (2G allele) at -1,607 bp in the promoter of the MMP-1 gene that creates a binding site for the ETS family of transcription factors, and that is associated with enhanced transcription of this gene and increased enzyme activity. Allelic loss at the MMP-1 locus on chromosome 11 occurs in many tumors including melanoma, an invasive and aggressive cancer. We hypothesized that although loss of either the 1G or 2G allele from 1G/2G heterozygotes is random, retention of the transcriptionally more active 2G allele would favor tumor invasion and metastasis. As a result, a higher proportion of metastases would contain the 2G genotype than the 1G genotype. We report here the development of quantitative methods for assessing allelic loss at the MMP-1 locus, and demonstrate that 83% of the metastatic melanomas with loss of heterozygosity at this locus retained the 2G allele. This supports the hypothesis that retention of the 2G allele favors tumor invasion and metastasis in melanoma.

Topics: Adult; Aged; Alleles; Base Sequence; Chromosomes, Human, Pair 1; DNA, Neoplasm; Electrophoresis; Female; Genotype; Humans; Loss of Heterozygosity; Male; Matrix Metalloproteinase 1; Melanoma; Middle Aged; Molecular Sequence Data; Mutagenesis, Insertional; Neoplasm Metastasis; Phosphorus Radioisotopes; Polymerase Chain Reaction; Polymorphism, Genetic; Polymorphism, Restriction Fragment Length; Polymorphism, Single Nucleotide; Promoter Regions, Genetic

The accurate assessment of microsatellite loci on specific chromosome regions for loss of heterozygosity (LOH) is important to identify potential tumor suppressor gene locations and recently correlations to clinicopathology of tumors. Analysis of microsatellite markers usually requires performing polymerase chain reaction (PCR) with labeled primers. This often leads to spurious PCR products that make interpretations of specific PCR bands difficult. Assessment of LOH by radiolabeled PCR is not always easy to interperet when there are multiple bands present, multiple markers and specimens are being assessed, and in multiplex LOH PCR. We describe an approach to accurately verify PCR-based LOH in which labeled PCR primers are not needed to detect allele expression. Specificity is determined by using a digoxigenin-labeled oligonucleotide (CA)13 as an internal specific probe for hybridization. Because the majority of di-nucleotide microsatellite markers contain the sequence of (CA)n or (GT)n repeats, this (CA)n probe is highly versatile. Forty cutaneous melanoma biopsies from advanced stage patients were assessed using the oligonucleotide probe at five chromosome regions (1q, 6q, 9p, 10q, 11q). The LOH frequency in informative cases varied from 33% to 47% in which chromosome 6q was the highest followed closely by 11q. We observed a higher frequency of LOH in the 6q (47%) and 11q (41%) compared to previously reported studies using the probe technique. This new approach was also demonstrated to be efficient in multiplex-PCR to detect LOH in melanomas. Using the probe hybridization approach it was demonstrated that in advanced cutaneous melanomas LOH are quite frequently expressed on 5 different chromosome regions.

Topics: Digoxigenin; Dinucleotide Repeats; DNA Probes; DNA, Neoplasm; Humans; Loss of Heterozygosity; Melanoma; Microsatellite Repeats; Phosphorus Radioisotopes; Skin Neoplasms

This study investigated the role of histologic tumor characteristics, in comparison with a normal tissue, and of tumor vascularization on the uptake and retention of colloidal 32P used in infusional brachytherapy of solid cancers. The cytotoxicity of colloidal 32P was also evaluated for two tumors of different radiosensitivity, a melanoma, and a squamous cell carcinoma.. An in vitro analysis of colloidal 32P uptake was carried out on a human melanoma cell line, HBL, a human squamous cell carcinoma, SCC1, and normal fibroblasts, F-NBB. Tumor retention of colloidal 32P was studied in vivo for the HBL and the SCC1 tumors implanted subcutaneously in nude mice. Tumor vascular density was determined by microscopic study of Masson's trichrome slides of HBL and SCC1 tumors of about 1 cm diameter.. In vitro studies showed that the time required for maximal cell uptake of colloidal 32P was only 10-20 min for the SCC1 and HBL tumors, while it took at least 60 min for the fibroblasts. After intratumoral injection of macroaggregated albumin (MAA), followed by 50 microCi of colloidal 32P, Bremsstrahlung imaging performed at 6 and 24 h showed that the activity remained in the HBL tumor while some of the radiocolloids leaked from the SCC1 tumor and was trapped in the reticuloendothelial system of the liver. Organ activity counting confirmed this finding: 32P activity was three to four times higher in the HBL than in the SCC1 tumor, whereas the activity in the liver, insignificant in the HBL mice (less than 0.1 microCi/g), was as high as 24 microCi/g in the SCC1 mice. This phenomenon may be explained by the difference in tumor vascular density, estimated for the HBL to be about four times less than that of the SCC1 tumor (5.7 vs. 21.4 blood vessels per mm2 for the HBL and the SCC1 tumors, respectively).. Intratumoral infusion of colloidal 32P may be a useful complement of radiation therapy in the treatment of nonresectable but accessible solid tumors. Tumor vascularization must be taken into account for a successful vascular blockade by MAA prior to the infusion of colloidal 32P.

Topics: Animals; Carcinoma, Squamous Cell; Colloids; Dose-Response Relationship, Radiation; Humans; Male; Melanoma; Mice; Mice, Nude; Phosphorus Radioisotopes; Serum Albumin; Tumor Cells, Cultured

Results of the 32P uptake test for the diagnosis of choroidal melanoma in 41 patients are reported. The sensitivity was 80%, the specificity 86%, if a count rate ratio of more than 1.4 between tumor and normal tissue was considered as pathological. Ratios between 1.4 and 1.6 ought to be considered as equivocal in which case specificity increases to 90%. The 32P uptake test still remains a method of clinical relevance in the diagnosis of choroidal melanoma.

Topics: Choroid Neoplasms; False Negative Reactions; False Positive Reactions; Humans; Melanoma; Phosphorus Radioisotopes; Sensitivity and Specificity

We have developed and compared two DNA dot hybridization methodologies with similar probes (radioisotope-labelled and biotin-labelled) to detect varicella-zoster virus (VZV) DNA in three different cell cultures at varying times post-infection. Control cultures included uninfected monolayers of the same cells. Cellular DNA was isolated by a standard phenol extraction method, after which the DNA was quantified, serially diluted and blotted onto nitrocellulose or nylon membranes. The VZV DNA probe, which consisted of the large Hind III A fragment (27 of the total 125 kbp), was produced in two separate nick translation systems. The first contained 100 microCi [32P] and 0.4 microgram Hind III fragment A of the varicella genome, while the second probe employed a biotin-7-dATP analogue and 1.0 microgram of the Hind III fragment A. Direct visualization on the membrane or the exposed radiographic film showed a dot of varying intensity whenever viral genome was detected with either the biotin or the radioactive probe, respectively. With the [32P]-labelled probe, we detected VZV genomic sequences within 0.5 microgram total DNA at 12 h post-infection. This amount corresponded to approximately 5-10 pg of viral DNA. By comparison, hybridization with the biotin-labelled probe required 0.5-1.0 micrograms total DNA from infected cells. Similar tests on DNA extracted from uninfected cell samples were negative with both probes.

Topics: Biotin; Cell Line; Cell Transformation, Viral; Cells, Cultured; Cornea; DNA Probes; DNA, Viral; Genes, Viral; Herpesvirus 3, Human; Humans; Melanoma; Nucleic Acid Hybridization; Phosphorus Radioisotopes; Protein Biosynthesis

Topics: Choroid; Choroid Neoplasms; Diagnosis, Differential; False Negative Reactions; Humans; Melanoma; Phosphorus Radioisotopes; Radionuclide Imaging; Uveal Diseases

In sixteen patients who had been treated 42 months before on an average for malignant melanomas of the lower extremity (stage I) by a unilateral endolymphatic therapy with 32P/131J-Lipiodol UF, bipedal lymphography with oily contrast medium was performed. In consequence of the high-dosed intralymphatic radiotherapy the lymph nodes of the treated side are markedly reduced in size and number; fourteen out of the sixteen patients, however, showed lymph nodes of normal size and structure which had not been coloured during ELRT. On the basis of this phenomenon, a possible mechanism of formation of metastases in previously treated lymph nodes is discussed. The presentation and extent of radiogenic reactions in the lymph vessels correspond to the changes known for percutaneous irradiation.

Topics: Diaphragm; Humans; Injections, Intralymphatic; Iodine Radioisotopes; Iodized Oil; Leg; Lymphatic System; Lymphography; Melanoma; Phosphorus Radioisotopes; Radioisotopes; Time Factors

A 32P uptake test to diagnose an intraocular tumour was performed on a lactating woman. Breast feeding of her infant had been stopped and after injection of the 32P, a sample of breast milk on two consecutive days was collected. The concentration of 32P in the milk was greater in the second sample than the first, but it was calculated that the potential whole body radiation dose to her infant on the second day would not have exceeded 180 microSv (18 mrem).

Topics: Adult; Breast Feeding; Ciliary Body; Female; Humans; Infant; Melanoma; Milk, Human; Phosphorus Radioisotopes; Radiation Dosage; Radionuclide Imaging; Risk; Time Factors; Uveal Neoplasms

The most frequently used radioisotope in ophthalmology is radioactive phosphorus (32P). Since its introduction into ophthalmology in 1951, it has been used primarily as an aid in the diagnosis of malignant melanoma of the choroid. During the thirty years of clinical use, the indications for this test have been clearly defined. The maximum tissue penetration of 32P is 7 mm. Surgical dissection is therefore frequently necessary to enable the ophthalmologist to place the Geiger-Muller probe on the sclera in proximity to the tumor. False positive and false negative results are unusual and the test is between 96% and 100% accurate.

Topics: Choroid Neoplasms; False Negative Reactions; False Positive Reactions; Humans; Melanoma; Phosphorus Radioisotopes; Radionuclide Imaging

The 32P uptake test used in the differential diagnosis of 912 cases yielded an accuracy rate of 94.82% for intraocular lesions behind the equator, and 85.15% for lesions of the anterior uvea. The highest error rate occurred in patients with suspected tumors of the iris and ciliary body. It seems advisable to take a 40% difference on the uptake as the limit between a positive or negative test result.

Topics: Adenoma; Choroid Neoplasms; Ciliary Body; Diagnosis, Differential; Eye Neoplasms; False Negative Reactions; False Positive Reactions; Humans; Iris Diseases; Melanoma; Phosphorus Radioisotopes; Retinal Hemorrhage; Sarcoma, Kaposi; Uveal Neoplasms

Topics: Adult; Aged; Female; Humans; Male; Melanoma; Middle Aged; Phosphorus Radioisotopes; Prognosis; Radionuclide Imaging; Ultrasonography; Uveal Neoplasms

Topics: Copper; Diagnosis, Differential; Diphosphates; Humans; Melanoma; Phosphorus Radioisotopes; Skin Neoplasms

A complex of new methods are proposed. They make it possible to improve the precision and informative value of the results of 32P diagnosis of pigmental skin tumors. The following methods are used: 1) fractional administration of the indicator to increase the level of 32P accumulation in melanomas; it made it possible to improve the differential-diagnostic capacity of the radiophosphorus test; 2) beta-radiometry of pathological and control skin zones with and without fine tissue equivalent filters to "contrast" tumors and to determine the average depth of their invasion to unchanged tissues; the use of this method made it possible to lessen the number of false-negative diagnoses and to get additional clinicodiagnostic information that can be useful in the planning of surgical and radiation treatment; 3) radiometry of skin zones in the spectrometric regimen with three different levels of the integral discrimination of beta-radiation impulses to determine the thickness and lower line of the layer of the abnormal accumulation of the indicator in the pathological skin zone; the use of this method makes it possible to detect incrusted melanomas.

Topics: Diagnosis, Differential; Humans; Mathematics; Melanoma; Methods; Neoplasm Invasiveness; Phosphorus Radioisotopes; Radionuclide Imaging; Skin; Skin Neoplasms; Tissue Distribution

Because of phosphorus involvement in metabolic processes, 32P is a suitable radioisotope for the investigation of the function of normal and malignant cells. The basic principles of the 32P test are analysed. This paper presents the results on a series of patients who underwent the 32P uptake test at the Ospedale Oftalmico of Turin. An evaluation of the dose to the patient is also presented.

Topics: Dose-Response Relationship, Radiation; Eye; Eye Neoplasms; Humans; Mathematics; Melanoma; Phosphorus Radioisotopes; Radiation Dosage; Radiography; Radiometry

The authors have determined the distribution of 32P in normal skin and in the case of certain skin tumours (basalioma and spinalioma). In both groups a lognormal distribution was found. It may be assumed that the enrichment is governed by similar distribution in the case of melanoma malignum.

Topics: Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Humans; Mathematics; Melanoma; Phosphorus Radioisotopes; Skin; Skin Neoplasms

Topics: Choroid Neoplasms; Fluorescein Angiography; Humans; Melanoma; Phosphorus Radioisotopes

32P-uptake over different tumor areas of 13 melanoma containing eyes was measured and samples of these areas histologically investigated, now mainly concerning the rate of mitosis. We found interindividually as well as intraindividually positive correlations between 32P-uptake, epitheloid-cell-content and mitoses.

Topics: Eye; Eye Neoplasms; Humans; In Vitro Techniques; Isotope Labeling; Melanoma; Mitosis; Phosphorus Radioisotopes

Topics: Adult; Aged; Female; Humans; Male; Melanoma; Middle Aged; Phosphorus Radioisotopes; Prognosis; Uveal Neoplasms

The ophthalmology radioactive phosphorus uptake test has been utilized in the differential diagnosis of intra ocular lesions in 21 patients. In the majority of the cases the diagnosis was histologically confirmed. When the lesion is located in the anterior part of the globe, it is not necessary to make an incision of the conjunctiva to perform the test. If the lesion is located in the posterior segment, the test is performed by the transscleral route, with surgical incision of the conjunctiva and with indirect ophthalmoscopy control when possible. In 3 patients with choroidal hemangioma were results false-positives, observed with inferior P32 uptake to that in patients with choroidal melanomas. One false-negative result was obtained in a patient with a clinical diagnosis of uveal malignant melanoma, histologically confirmed after enucleation of the globe. In all others patients with uveal malignant melanoma results were highly positive.

Topics: Choroid Neoplasms; Diagnosis, Differential; Diagnostic Errors; Eye; Eye Diseases; Eye Neoplasms; Hemangioma; Humans; Melanoma; Phosphorus Radioisotopes; Radionuclide Imaging

Topics: Female; Humans; Immunity, Cellular; Injections, Intralymphatic; Male; Melanoma; Middle Aged; Phosphorus Radioisotopes; Radiotherapy; Skin Neoplasms

Topics: Adult; Aged; Humans; Melanoma; Middle Aged; Phosphorus Radioisotopes; Radioactivity; Uveal Neoplasms

In vivo and in vitro measurements of radioactive phosphorus uptake after intravenous injection of P32 in 26 cases of malignant melanoma of the choroid is reported. The specific radioactivity of dissected ocular tissue after enucleation is described. No statistically significant relationship between the radioactive phosphorus uptake and the histologically differentiated cell type was found. It was possible to demonstrate the P32 uptake as a function of the mass of the tumor.

Topics: Choroid Neoplasms; Eye; Humans; Melanoma; Phosphorus Radioisotopes; Radionuclide Imaging

Values for radioactive phosphorus uptake from 23 eyes with malignant melanomas of the choroid were compared before and after enucleation. In all but two eyes, the percentage increase in 32P uptake was higher immediately after enucleation than before enucleation. In 11 eyes, the variation was more than 100%. In one eye, the percentage increase of 32P uptake was 68% before enucleation and 137% after enucleation. The clinical importance of our findings is that pressure on the globe by the detector probe before enucleation may locally decrease choroidal blood volume thereby causing an increase in the calculated 32P uptake.

Topics: Blood Volume; Choroid Neoplasms; Humans; Intraocular Pressure; Melanoma; Phosphorus Radioisotopes

A complex examination by radio-isotope (32P) and thermographic methods was carried out in 252 patients, 122 patients underwent surgery. The complex diagnostic study established the following three groups: test-positive, test-negative and test-suspected patients. Application of the complex (radioisotope and thermographic) examination technique provides a more adequate visualization of tumor process and, therefore, a better opportunity for selection of correct treatment. The application of the thermographic method is recommended for screening for subjects at high risk of malignant disease of the skin.

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Diagnosis, Differential; Female; Humans; Lymphatic Metastasis; Male; Melanoma; Middle Aged; Nevus, Pigmented; Phosphorus Radioisotopes; Pigmentation Disorders; Radionuclide Imaging; Skin Neoplasms; Thermography

A 57-year-old Caucasian woman was found, on a routine ophthalmoscopic examination, to have a pigmented ciliary body mass suggestive of a malignant melanoma. The eye was enucleated primarily because a radioactive phosphorus test yielded a 79% greater uptake over the lesion than over a control area-a result regarded as positive at that time. Histopathologically, the lesion proved to be a benign melanocytoma of the ciliary body. Electron microscopy clearly revealed a large complement of inflammatory cells (macrophages) within the tumor. This case reemphasizes the advisability of carefully documenting tumor growth before enucleating eyes harboring pigmented lesions.

Topics: Ciliary Body; Diagnostic Errors; Eye Neoplasms; False Positive Reactions; Female; Humans; Melanoma; Middle Aged; Nevus, Pigmented; Phosphorus Radioisotopes; Radionuclide Imaging; Uveal Diseases

Five eyes containing choroidal melanomas were found, on histopathologic examination, to have traumatic episcleritis with foreign-body granulomas and scleral edema underlying the area of tumor. This reaction was clearly correlated with phosphorus 32 testing that had been performed one to four weeks earlier. In all cases, enucleation had been delayed for logistic reasons. Invasion of the sclera or intrascleral canals was found in each case, with extension to the episclera in two of three small melanomas. Although the cases are few, this degree of invasion was greater than that seen in our other small melanomas or in reported series. The possibility that manipulation and inflammation of this type might have an adverse stimulatory influence on some melanomas should be considered when planning delayed enucleation after 32P testing. The juxtaposition of cautery marks and intrascleral tumor in a further case of melanoma demonstrates another possible complication of 32P testing.

Topics: Aged; Choroid Neoplasms; Female; Foreign-Body Reaction; Humans; Inflammation; Male; Melanoma; Middle Aged; Neoplasm Invasiveness; Phosphorus Radioisotopes; Radionuclide Imaging; Sclera

Topics: Adult; Diagnosis, Differential; Female; Humans; Male; Melanoma; Middle Aged; Phosphorus Radioisotopes; Radionuclide Imaging; Skin Neoplasms

The concentration of radioactive phosphorus in uveal melanoma and normal parts of the eye was determined in vitro in 14 eyes. The eyes were enucleated after a positive 32P uptake test. Portions of the melanoma as well as normal choroid, retina, sclera, lens, and vitreous were analyzed. The 32P uptake test had been performed at various intervals after intravenous administration of 32P from 24 to 556 hr. The in vitro uptake of 32P was compared to cell type, tumor volume, time of testing, percent uptake measured clinically, and specific activity. The only positive correlation was between percent uptake measured clinically and 32P concentration (dpm/gm). A higher concentration of phosphorus in melanoma resulted when carrier-free 32P was used. A negative correlation existed between number of hours from injection to clinical measurement of percent uptake, although melanoma to normal choroid ratios did not change from 24 to 72 hr. No correlation was found between uptake and tumor volume. The sample was small; however, we saw no correlation between 32P uptake and degree of malignancy.

Topics: Aged; Choroid Neoplasms; Eye; Female; Humans; In Vitro Techniques; Male; Melanoma; Middle Aged; Mitosis; Ophthalmologic Surgical Procedures; Phosphorus Radioisotopes

Topics: Choroid Neoplasms; Fluorescein Angiography; Humans; Melanoma; Phosphorus Radioisotopes; Radionuclide Imaging; Serologic Tests; Ultrasonography

An infrared sensor was inserted at the film plane of a fundus camera. The signal was visualized on an oscilloscope. In this manner we measured infrared reflectance from the surface of the fundus. The purpose was to characterize choroidal malignant melanomas more reliably than is done with infrared color translation photography. Control lesions were choroidal nevi, metastatic tumors, and disciform macular degenerations. Correlations were made with radioactive phosphorus (32P) uptake, fluorescein angiography, and histopathologic findings. Several cases are presented, one in which this new method of infrared detection was the first diagnostic test to detect the spread of a choroidal melanoma. The simplicity of this technique and its increased accuracy justify the needed further refinements.

Topics: Adult; Aged; Choroid Neoplasms; Female; Fluorescein Angiography; Fundus Oculi; Humans; Infrared Rays; Macular Degeneration; Melanoma; Middle Aged; Neoplasm Metastasis; Nevus; Phosphorus Radioisotopes; Photography; Ultrasonography

Current follow-up information was obtained for 91 of 100 patients with tumors of the uveal tract for whom transscleral 32P tests had been performed and the eye had been enucleated because of malignant melanoma. The 32P uptake test was found to correlate better with outcome than either mitotic activity or invasion of the sclera. However, the correlation was not as good as that observed for tumor size and cell type. While most of the prognostic information in the 32P uptake value could be determined from the size of the tumor, none of the 13 tumors with 32P uptake less than 100% developed metastatic melanoma. The amount of necrosis within the tumor correlated with a bad prognosis and lower 32P uptake. There were three cases of spindle-cell nevi, all with positive 32P uptake values and none with metastasis.

Topics: Choroid Neoplasms; Follow-Up Studies; Humans; Melanoma; Neoplasm Metastasis; Phosphorus Radioisotopes; Prognosis

Endolymphatic radionuclide therapy (ELRT) produces not only a radiotherapeutic effect on the lymph nodes but makes possible also to judge of the lymph nodes being stained with labelled lipiodol UF. With the purpose of avoiding an eventual radiation exposure of the lung, or at least of confining it to a minimum, only limited quantities not exceeding 3.5 ml (5 mCi of 32P; 0.5 mCi of 131I) of the oily contrast medium for unilateral, or twice 3.5 ml (together 4 mCi of 32P; 0.5 mCi of 131I) for bilateral application. A retrospective analysis of 245 patients of the study group for endolymphatic radionuclide therapy, who suffered from malignant melanomas of the inferior limbs, revealed 77.5% of correct diagnoses. Most of the false-positive findings (44/70) seem to be due to the knowledge of the primary disease, as 77% of these cases had been described as "suspicious". False-negative findings turned out in 5% only. The findings which had been characterized as "surely positive" proved reliable in 90%. The good results of lymphography with smaller quantities of the contrast medium are, on the whole, comparable to those of primary diagnostic lymphography.

Topics: Female; Humans; Iodine Radioisotopes; Leg; Lymphatic Metastasis; Lymphography; Male; Melanoma; Middle Aged; Phosphorus Radioisotopes

Topics: Adult; Diagnosis, Differential; Female; Humans; Male; Melanoma; Methods; Middle Aged; Nevus, Pigmented; Phosphorus Radioisotopes; Skin Neoplasms

The radioactive phosphorus (32P) uptake test used in ocular tumor evaluation in 408 cases achieved an overall percentage error rate of 3.6%. This compared favorably with the clinical error rate of 19.2% overall. The least accuracy was obtained in cases with ciliary body lesions.

Topics: Adolescent; Adult; Aged; Child; Choroid Neoplasms; Eye Neoplasms; False Negative Reactions; False Positive Reactions; Female; Humans; Male; Melanoma; Middle Aged; Nevus, Pigmented; Phosphorus Radioisotopes; Uveal Neoplasms

A report on results of 186 32P tests is given. Radiation increases of more than 30%, compared with tumor-free areas, were considered as positive. 95 eyes were histologically examined. The 32P test gave 90 correct positive answers and 1 correct negative answer. Faulty positive results were found in 2 cases; faulty negative results were also found in 2 cases. This means that the diagnosis was correct in 95%. The literature is discussed concerning reliability and methods. The dangers of the use of 32P are stressed, and the development of noninvasive nuclear-medical diagnostic methods is suggested.

Topics: Choroid Neoplasms; Ciliary Body; Diagnosis, Differential; Eye Neoplasms; Humans; Iris; Melanoma; Phosphorus Radioisotopes; Radionuclide Imaging; Uveal Neoplasms

Topics: Humans; Lymphatic Metastasis; Melanoma; Methods; Neoplasm Staging; Phosphorus Radioisotopes; Radionuclide Imaging; Skin Neoplasms

Topics: Choroid Neoplasms; False Negative Reactions; False Positive Reactions; Hemangioma; Humans; Melanoma; Neoplasm Metastasis; Nevus; Ophthalmologic Surgical Procedures; Phosphorus Radioisotopes; Radionuclide Imaging

Handle probe and counting system for radiophosphorus test can be checked by the use of a 64 nCi Strontium-90 radiator established inside a plexiglas cylinder. Counting system adjustment to 40 dB amplifier and 0.70 discriminator resulted in 1710cpm+/-2% standard deviation. This check method is suitable for controlling the counting system before tumor measurement. Advantages of this test method are low expenses, stability of the radionuclide, and riskless use of beta-radiator.

Topics: Choroid Neoplasms; Humans; Melanoma; Phosphorus Radioisotopes; Radionuclide Imaging; Scintillation Counting

We compared 19 choroidal hemangiomas and 21 choroidal melanomas of comparable size as to the percent of radioactive phosphorus 32P uptake. The results were significantly lower in choroidal hemangiomas than in comparable sized melanomas.

Topics: Choroid Neoplasms; Diagnosis, Differential; False Positive Reactions; Hemangioma; Humans; Melanoma; Phosphorus Radioisotopes; Radionuclide Imaging

A benign adenoma of the pigment epithelium of the ciliary body in a 27-year-old woman simulated a malignant melanoma clinically and resulted in enucleation. The correct diagnosis was not made clinically despite the use of A- and B- scan ultrasonography and the radioactive phosphorus (32P) uptake test, procedures which are usually reliable in differentiating between melanoma and pseudomelanoma. We emphasize the shortcomings of these ancillary tests in differentiating pigment epithelial tumors from malignant melanoma.

Topics: Adenoma; Adult; Ciliary Body; Diagnosis, Differential; Diagnostic Errors; Eye Neoplasms; Female; Humans; Melanoma; Ophthalmoscopy; Phosphorus Radioisotopes; Pigment Epithelium of Eye; Ultrasonography; Vision Disorders; Visual Acuity

Topics: Diagnosis, Differential; Humans; Melanoma; Phosphorus Radioisotopes; Radionuclide Imaging; Skin Neoplasms

The author reports about the radio-phosphorus-test as an additional method in diagnostics of intraocular tumors in 62 examinations. The conformity between 49 histologically examined cases and the positive test-results amounted to 90%.

Topics: Choroid Neoplasms; Eye Neoplasms; Humans; Melanoma; Methods; Phosphorus Radioisotopes; Radionuclide Imaging

Topics: Female; Humans; Lymph Nodes; Lymphatic Metastasis; Male; Melanoma; Palliative Care; Phosphorus Radioisotopes; Prognosis; Skin Neoplasms; Time Factors

A 62-year-old white female was found to have a small, flat pigmented choroidal tumor. After fluorescein angiography and a positive P-32 test, the eye was enucleated for presumed malignant melanoma. Histologically, the tumor proved to be a choroidal nevus with a break in Bruch's membrane and a subretinal-pigment-epithelial neovascular membrane.

Topics: Diagnosis, Differential; Eye Neoplasms; Female; Humans; Melanoma; Middle Aged; Nevus, Pigmented; Phosphorus Radioisotopes; Pigment Epithelium of Eye

Endolymphatic isotope therapy had such promising early clinical results that the M.R.C. (Medical Research Council) U.K. set up a clinical trial in 1966. This was to compare the effect of endolymphatic isotope therapy with the results of standard methods in the treatment of lower limb malignant melanoma. The interim report had three groups for analysis: Standard Methods (S); Endolymphatic Satisfactory (ES); and Endolymphatic Unsatisfactory (EU). This third group was a subdivision, as a significant number of patients did not have the correct endolymphatic treatment. The five-year survival figures expressed as actuarial percentages were ES=78.8%; S=82.3%; and EU=57.3%. Lymph node recurrence showed a significant difference: ES=2.3%; EU=12%; and S=19%. The conclusions were that endolymphatic isotope therapy was justified in specialized centres where good results could be obtained. Further animal experiments using the VX2 tumour in rabbits indicated that BCG given intracutaneously or intravenously had no therapeutic effect, whereas when applied by intralymphatic injection BCG was successful in treating lymph node metastases. Nineteen patients with poor-prognosis malignant melanoma have received endolymphatic BCG. The clinical results are recorded in this paper and are sufficiently encouraging to warrant its continued use.

Topics: Animals; BCG Vaccine; Female; Humans; Injections, Intralymphatic; Iodine Radioisotopes; Lymphatic Metastasis; Male; Melanoma; Middle Aged; Neoplasms, Experimental; Phosphorus Radioisotopes; Rabbits; Skin Neoplasms

An amelanotic fundus lesion in a 35-year-old man was associated with a dilated retinal vessel, thus suggesting the diagnosis of retinal angioma. Fluorescein angiography and B-scan ultrasonography were not diagnostic, but a radioactive phosphorus uptake test suggested the lesion was malignant. The enucleated globe showed a malignant choroidal melanoma drained by a large retinal vein.

Topics: Adult; Choroid Neoplasms; Ciliary Body; Diagnosis, Differential; Eye Neoplasms; Fluorescein Angiography; Hemangioma; Humans; Male; Melanoma; Nerve Fibers, Myelinated; Phosphorus Radioisotopes; Retina; Retinal Vessels

In the radiological hospital of Essen, 139 patients with malignant melanomas on the extremities have been submitted to an endolymphatic radionuclide therapy between May 29, 1970 and January 1, 1976. The survival rates of the different tumor stages are indicated and the changes of the survival curves since the last evaluation of August 31, 1973 are discussed. If the endolymphatic radionuclide therapy is applied, there is no risk of important side effects or complications. If an adequate surgical therapy has been effected prior to the radiotherapy, we consider the endolymphatic radionuclide therapy to be indicated above all in case of a malignant melanoma of the clinical stage I or II when the primary tumor is situated in the lower extremity.

Topics: Female; Humans; Iodine Radioisotopes; Leg; Lymphatic System; Lymphography; Male; Melanoma; Methods; Middle Aged; Phosphorus Radioisotopes; Radiotherapy Dosage; Time Factors

We studied four patients with posterior brawny scleritis. Two underwent enucleation for suspected melanoma, and in the other two, the correct diagnosis was made and effective therapy begun. Of seven other eyes with brawny scleritis from other sources, five were enucleated after diagnosis of choroidal melanoma and one for suspected intraocular tumor. This experience and other previous reports indicate the high incidence of diagnostic confusion regarding brawny scleritis. We therefore emphasized clinical symptoms and signs of brawny scleritis: inflammation, tenderness or pain of the globe, history of collagen vascular disease, proptosis, bilaterality, and retinal and choroidal detachment. A preserved normal choroidal vascular pattern over an elevated subretinal mass may be indicative of posterior brawny scleritis. Scleral biopsy is useful for tissue diagnosis. Radioactive phosphorus uptake tests and ultrasonography may erroneously indicate choroidal melanoma and lead to enucleation of a potentially salvageable globe.

Topics: Adult; Aged; Choroid Neoplasms; Diagnosis, Differential; Diagnostic Errors; Exophthalmos; Female; Humans; Inflammation; Male; Melanoma; Middle Aged; Pain; Phosphorus Radioisotopes; Retinal Detachment; Sclera; Ultrasonography

We report the clinical and histopathologic features of an osseous choristoma of the choroid that appeared in a 26-year-old woman. Her diagnostic evaluation included a radioactive phosphorus (32P) uptake test, which was 270% positive and led us to believe that the lesion was an atypical malignant melanoma. The extent of true ossification within this tumor, seen microscopically, explains the false-positive uptake of radioactive phosphorus by this benign tumor; it is well known that bone avidly accumulates radioactive phosphorus. We recommend that all "atypical choroidal melanomas" be studied for the presence of bone, with bone-free roentgenograms, ultrasonography, and possibly, computerized tomographic scans before 32P testing or enucleation. This, to our knowledge, is the second histopathologically proved case of an osseous choristoma of the choroid to be reported in the literature.

Topics: Adult; Bone and Bones; Choristoma; Choroid Neoplasms; Diagnosis, Differential; Female; Fluorescein Angiography; Humans; Melanoma; Phosphorus Radioisotopes

The accurate and early diagnosis of intraocular malignant melanoma in eyes with opaque media remains a diagnostic problem. Ultrasonography and the radioactive phosphorus (32P) uptake test have been used separately as modalities for diagnosis of choroidal melanoma. However, their combined use has received limited attention. This report presents our experience in 5 cases with the combined use of a contact B-scan ultrasound unit and a posterior eye probe. In all cases we were able to accurately perform the 32P uptake test with simultaneously ultrasound visualization of the tumor and the probe.

Topics: Aged; Catheterization; Choroid Neoplasms; Female; Fluorescein Angiography; Humans; Male; Melanoma; Middle Aged; Phosphorus Radioisotopes; Retinal Diseases; Ultrasonics; Ultrasonography

Three patients had suspected choroidal melanoma and positive results for radioactive phosphorus (32P) uptake tests, leading to enuclearion in two of the patients. No malignancy was present on histopathologic examination. This experience reemphasizes the need for the ophthalmologist to evaluate the total clinical picture and not to give inappropriate consideration to a "positive" 32P uptake test in deciding for or against enucleation in a suspected choroidal melanoma. The positive 32P uptake test, even with high values, cannot be equated with malignancy, and a variety of nonmalignant lesions may give false-positive results.

Topics: Adult; Choroid Neoplasms; Diagnostic Errors; Evaluation Studies as Topic; Female; Humans; Melanoma; Middle Aged; Phosphorus Radioisotopes; Sclera

Topics: Adolescent; Choroid Neoplasms; Ciliary Body; Conjunctiva; Diagnosis, Differential; Diagnostic Errors; Evaluation Studies as Topic; Eye Neoplasms; Humans; Iris; Lymphoma; Melanoma; Neoplasm Metastasis; Phosphorus Radioisotopes; Retinoblastoma

Topics: Choroid Neoplasms; Female; Hemorrhage; Humans; Melanoma; Middle Aged; Phosphorus Radioisotopes

Many of the difficulties in diagnosing choroidal melanomas which confronted clinicians in the past have now been eliminated. This is due to greater clinical awareness of melanomas and pseudomelanomas, as well as the use of indirect ophthalmoscopy and other ancillary tests. With further investigation, other diagnostic techniques may be developed for clinical use.

Topics: Choroid Neoplasms; Eye Neoplasms; Fluorescein Angiography; Humans; Melanoma; Phosphorus Radioisotopes; Transillumination; Ultrasonography; Uveal Diseases

A chorioretinal granuloma that contained acid-fast bacilli and a choriodal nevus that consisted of benign nevus cells yielded false-positive radioactive phosphorus tests. The beta emission exceeded that of the control areas by more than 100% in each case. The granuloma had infiltrated the sclera, permitting inflammatory tissue to be in closer proximity to the counting probe than was the normal choroid. The reason for the increased metabolic activity of the nevus cells remains unexplained.

Topics: Adult; Aged; Choroid; Choroid Neoplasms; False Positive Reactions; Female; Fluorescein Angiography; Granuloma; Humans; Male; Melanoma; Phosphorus Radioisotopes; Retinal Diseases; Ultrasonography; Uveal Diseases

The radioactive phosphorus uptake of 30 samples fron nine uveal melanomas was determined by liquid scintillation counting. These in vitro measurements correlated positively with clinical (in vivo) 32P values and with the number of mitotic figures and percentage of epithelioid cells (PEC) within the specimens. Three possible explanations were found for the failure of previous workers to demonstrate a correlation between cell type and clinical 32P. (1) Cell type, using Callender's classification, provides only a crude estimate of the PEC within a tumor; in particular, tumors of mixed cell type can vary widely in epithelioid cell content. (2) The rate of 32P absorption is not su-ficiently sensitive to distinguish spindle cell tumors from mixed cell tumors with a low PEC. (3) Clinical 32P measurements may be affected by extraneous factors that cause large deviations from the expected values.

Topics: Choroid Neoplasms; Ciliary Body; Eye Neoplasms; Humans; In Vitro Techniques; Melanoma; Phosphorus Radioisotopes; Scintillation Counting

Of 358 eyes enucleated between 1962 and 1975, and found to contain posterior uveal melanomas, 31 had opaque media (8.6%). Eighteen of these patients with opaque media were seen between 1962 and 1971, before the use of combined ultrasonography and the radioactive phosphorus uptake (32P) test. Melanoma was unsuspected at enucleation in one third of these patients and there was often a long delay in diagnosis. Of the 13 patients seen between 1971 and 1975, after the initiation of combined ultrasonography and 32P) test, there was no delay in diagnosis becuase a melanoma pattern was recognized immediately with ultrasonography and confirmed with a positive 32P test. During the latter part of this study, 19 patients with opaque media had a "melanoma pattern" with ultrasonography. The 32P test was positive in 12 cases and a melanoma was confirmed histologically in every instance. The 32P test was negative in seven cases and all were documented on follow-up to have benign lesions, such as subretinal hemorrhages.

Topics: Adolescent; Adult; Aged; Cataract; Diagnosis, Differential; Eye Neoplasms; Female; Glaucoma; Humans; Male; Melanoma; Middle Aged; Panophthalmitis; Phosphorus Radioisotopes; Retinal Detachment; Retinal Hemorrhage; Ultrasonography; Uveal Diseases

Results from a 32P test in a histologically proven choroidal hemangioma were normal in a case we recently evaluated. It is believed that this case is important because of the infrequent number of confirmations with this test.

Topics: Adult; Choroid Neoplasms; Diagnosis, Differential; Female; Hemangioma; Humans; Melanoma; Phosphorus Radioisotopes

The ultrasonic examination gives no answer as to the metabolic activity of pathological intraocular tissue. Therefore, the combination with the 32P uptake test is great clinical value. The diagnosis of intraocular tumors is possible with a 95% certainty. A new probe with a Si(Li) semiconductor detector is presented.

Topics: Choroid Neoplasms; Ciliary Body; Eye Neoplasms; Humans; Melanoma; Phosphorus Radioisotopes; Semiconductors

Topics: Choroid Neoplasms; Humans; Melanoma; Phosphorus Radioisotopes; Time Factors

A malignant melanoma of the choroid presented with a massive vitreous hemorrhage which prevented any view of the posterior pole. The diagnosis was confirmed by the results of a radioactive phosphorus test and ultrasonography. In eyes with opaque media, these tests will ofter prevent delays in diagnosis.

Topics: Aged; Choroid; Choroid Neoplasms; Eye Diseases; Hemorrhage; Humans; Male; Melanoma; Phosphorus Radioisotopes; Radionuclide Imaging; Ultrasonography; Vitreous Body

Topics: Dysgerminoma; Humans; Lymphatic System; Melanoma; Neoplasms; Phosphorus Radioisotopes

A quantitative, digital-output, whole-body scanner in a low background area has been used in the dosimetry of 32P/131I Lipiodol for intralymphatic radiotherapy. Five patients with malignant melanoma received intralymphatic administrations of Lipiodol labelled with 6 mCi 32P and 1.5 mCi 131I. The 131I is used primarily as a tracer for external measurements and the 32P as the chief therapeutic agent. Whole body scans were made at intervals for up to 15 days using the digital scanner, with the spectrometer set over the 364 keV photopeak of 131I. On the same occasions complete gamma-spectra were obtained for these patients using a 2 m arc, single detector whole body counter. The method used in estimating the activity at various sites in the body from the digital whole body scans is described and problems that arise in using 131I as a tracer for 32P Lipiodol in this work are discussed. For the administered activities mentioned above, maximum absorbed doses to the lymph nodes were found to range from 30-96 krad with a mean value of 51 krad. Uptake of radioactivity was also found in the lungs, resulting in absorbed doses of 350-960 rad with a mean value of 540 rad.

Topics: Adult; Aged; Computers; Female; Humans; Iodine; Iodine Radioisotopes; Iodized Oil; Lung; Lymph Nodes; Melanoma; Middle Aged; Phosphorus Radioisotopes; Radionuclide Imaging; Radiotherapy Dosage; Time Factors

Endolymphatic radiotherapy with 4 mCi32P tri-n-octylphosphate and 1 mCi 131 I triolein LIPIODOL UF has been performed in 75 patients suffering from malignant melanoma of the lower extremity. On the average, 13.3% of the radioactive substance remains in the syringes and connecting tubes. In most patients the radioactive material available for therapeutic irradiation is further reduced due to contamination of operation sheets and swabs (mean: 15.3%). There is, however, still sufficient radioactivity remaining for effective internal irradiation of the lymph nodes. The average radiation dose absorbed by the lymphatic tissue is 90.998 rad. The method is limited by the hazard of radiation damage to the lungs. Almost 80% of these patients had detectable concentrations of radioactivity in the lung fields. The average radiation dose was found to be 299 rad. So far radiation induced fibrosis has bot been observed in this series.

Topics: Humans; Iodine Radioisotopes; Iodized Oil; Lung; Lymph Nodes; Lymphatic Metastasis; Melanoma; Phosphorus Radioisotopes; Radiation Dosage; Radiography; Radiotherapy Dosage

In localized malignant melanoma, preoperative irradiation with fast electrons followed promptly by operation is recommended. With melanomas of the lower extremities additional endolymphatic radiotheraphy (32-P) is given. The present authors results with 139 patients are comparable with those presented by Edwards (London) and Ariel (New York). Cutaneous spread or lymph-node metastases should be excised widely and this should be followed by irradiation, fast electrons being preferable.

Topics: Electrons; Germany, West; Humans; Injections, Intralymphatic; Lymph Node Excision; Lymphatic Metastasis; Melanoma; Phosphorus Radioisotopes; Radiotherapy, High-Energy; Skin Neoplasms

Topics: Adolescent; Adult; Aged; Cataract; Evaluation Studies as Topic; Eye Diseases; Eye Neoplasms; Female; Hemorrhage; Humans; Male; Melanoma; Middle Aged; Panophthalmitis; Phosphorus Radioisotopes; Retinal Detachment; Time Factors; Ultrasonography; Uveal Diseases; Vitreous Body

Radioactive phosphorus uptake (32P) testing was performed on implanted uveal melanomas in the rabbit to determine how the percentage uptake value was affected by the dose of 32P and by the interval of time between 32P administration and 32P counting. There was no difference in percentage uptake comparing doses of 50, 100, and 200 muCi/kg, but these were relatively high doses. There was no difference in the mean percentage uptake value at two, five, or nine days after 32P administration. The range of percentage uptake values widened with successive days.

Topics: Animals; Eye Neoplasms; Melanoma; Neoplasm Transplantation; Neoplasms, Experimental; Phosphorus Radioisotopes; Rabbits; Time Factors; Uvea

Topics: Evaluation Studies as Topic; Eye Neoplasms; Hemangioma; Humans; Lymphangioma; Melanoma; Neoplasm Metastasis; Nevus; Phosphorus Radioisotopes

Topics: Choroid Neoplasms; Diagnosis, Differential; Diagnostic Errors; Eye Neoplasms; False Negative Reactions; False Positive Reactions; Hemangioma; Humans; Melanoma; Methods; Phosphorus Radioisotopes; Uvea

Two false-negative results from 32P testing for histologically verified malignant melanomas of the choroid are reported. In the first case, a haemorrhagic choroidal detachment caused an increase in probe; additionally, the tumour was necrotic. Both factors are likely to have contributed to the false-negative result. A satisfactory explanation for the false-negative result in the second case was not determined, although it may have accurately reflected a period of minimal tumour activity, inasmuch as repeat 32P testing was strongly positive eight months later, when unequivocal evidence of tumour growth was present. An alternative explanation is that the orally administered 32P was incompletely absorbed. Since 32P testing is frequently accompanied by significant manipulation both in the manoeuvre associated with tumour localization and in that associated with the actual radioactive counting, it would seem desirable to perform indicated enucleation immediately after completion of the 32P testing. While the properly performed 32P test remains a valuable diagnostic test for helping to establish the presence or absence of malignancies of the posterior globe, it is important to guard against the tendency to underestimate careful clinical evaluation.

Topics: Aged; Choroid Neoplasms; False Negative Reactions; Female; Humans; Melanoma; Phosphorus Radioisotopes; Retinal Detachment

Twenty-nine patients who had undergone enucleation for ocular malignant melanoma were studied. The results of the radioactive phosphorus uptake (32P) tests were correlated with histopathologic observations. There was a positive correlation between the 32P test results and the histologic degree of malignancy. Mixed cell melanomas were more frequent in the patients ranked with higher 32P test results. Spindle cell melanomas occurred more frequently in patients with lower 32P test results. Mitoses per field and degree of malignancy correlated positively with 32P test results when ranked in a masked manner by two ocular pathologists. Tumor volume and clinical factors did not correlate with the 32P test results. While patients with mixed cell melanomas had higher mean 32P test results than those with spindle cell melanomas, a large variance was noted. Because of this the 32P test is unreliable in predicting the histopathology of a tumor in individual cases.

Topics: Aged; Choroid Neoplasms; Ciliary Body; Eye Neoplasms; Female; Humans; Male; Melanoma; Middle Aged; Phosphorus Radioisotopes; Prognosis; Uvea

In 21 patients with a variety of skin tumors (squamous cell carcinomas, malignant melanomas, basal cell epitheliomas and mycosis fungoides) or pre-cancerous lesions (Bowen's disease, actinic keratosis, junctional nevus cell nevus) the radioactive phosphorus uptake test demonstrates a significantly increased concentration of P32 in those tumors. There were no false negative tests. The possibility of differentiation of malignant melanoma from benign nevus cell nevus and the early recognition of cutaneous metastases is described. Furthermore recurrence of previously irradiated or excised basal cell epitheliomas can be detected without a biopsy. No hematological side-effects were observed.

Topics: Aged; Bowen's Disease; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Diagnosis, Differential; False Negative Reactions; Female; Humans; Keratosis; Male; Melanoma; Middle Aged; Mycosis Fungoides; Neoplasm Metastasis; Neoplasm Recurrence, Local; Nevus, Pigmented; Phosphorus; Phosphorus Radioisotopes; Precancerous Conditions; Radionuclide Imaging; Skin Neoplasms

Topics: Choroid Neoplasms; Humans; Melanoma; Ophthalmology; Phosphorus Radioisotopes; Technology, Radiologic

A 57-year-old white woman presented with a small malignant melanoma of the choroid in the macular area of the right eye. The lesion failed to produce a visual field defect or to show fluorescence with angiography, but the radioactive phosphorus uptake(P) test was positive. Histologically, the retinal pigment epithelium was intact over the tumor and the sensory retina was normal. This unusual finding was the most likely explanation for the normal visual field. The intact retinal pigment epithelium over this nonfluroescent melanoma suggests that the destruction of the retinal pigment epithelium occurring with most choroidal melanomas may partially explain why these tumors usually demonstrate fluorescence. This case emphasizes the great accuracy of the P test for diagnosing small malignant tumors of the choroid, even before other popular diagnostic modalities indicate the malignancy of the lesion.

Topics: Choroid; Choroid Neoplasms; Female; Fluorescein Angiography; Fluorescence; Humans; Melanoma; Middle Aged; Ophthalmoscopy; Phosphorus Radioisotopes; Photomicrography; Retina; Ultrasonography

Topics: Choroid Neoplasms; Humans; Melanoma; Phosphorus Radioisotopes; Statistics as Topic

A case of malignant melanoma involving the regional lymphnodes was treated by endolymphatic isotope therapy. Because of the great diameter the radiation of some metastases was not completely sufficient. Fluorescent and living cells of malignant melanoma between damaged cells could be seen in the center of these metastases. Melanophages surrounded concentrically the central part of the metastases enclosing the melanoma cells. It is shown that in the search and identification for pigment producing melanoma cells the fluorescent histochemical method of Falck-Hillarp is superior to usual light microscopical methods. Beyond of this, the phenomenon of fluorescence in malignant melanoma cells probably is an indication for the vitality of these cells.

Topics: Aged; Humans; Iodine Radioisotopes; Lymph Nodes; Lymphatic Metastasis; Lymphography; Male; Melanoma; Microscopy, Fluorescence; Phosphorus Radioisotopes; Skin Neoplasms; Toes

Topics: Adolescent; Adult; Choroid Neoplasms; Diagnosis, Differential; Female; Humans; Male; Melanoma; Middle Aged; Neoplasm Metastasis; Phosphorus Radioisotopes

Topics: Choroid Neoplasms; Hemangioma; Humans; Melanoma; Phosphorus Radioisotopes; Radionuclide Imaging; Technetium

Topics: Humans; Lymph Nodes; Lymphatic Metastasis; Melanoma; Palliative Care; Phosphorus Radioisotopes; Radiation Effects; Radiotherapy Dosage; Radiotherapy, High-Energy; Skin Neoplasms

Topics: Extremities; Humans; Injections, Intralymphatic; Iodized Oil; Melanoma; Pharmaceutical Vehicles; Phosphorus Radioisotopes; Skin Neoplasms

Topics: Humans; Melanoma; Phosphorus Radioisotopes; Skin Neoplasms

Topics: Choroid Neoplasms; Diagnostic Errors; Humans; In Vitro Techniques; Melanoma; Phosphorus Radioisotopes

Topics: Adult; Female; Humans; Melanoma; Middle Aged; Phosphorus Radioisotopes; Skin Neoplasms

Topics: Catheterization; Lymphography; Melanoma; Phosphorus Radioisotopes

Topics: Gold Isotopes; Humans; Iodine Radioisotopes; Leg; Lymph Node Excision; Lymphatic Metastasis; Melanoma; Phosphorus Radioisotopes; Prognosis; Radioisotopes; Recurrence

Topics: Animals; Calcium; Carcinoma, Hepatocellular; Lanthanum; Leukemia, Experimental; Liver Neoplasms; Lymphoma, Non-Hodgkin; Magnesium; Melanoma; Mice; Neoplasms, Experimental; Phosphates; Phosphorus Radioisotopes; Sarcoma, Experimental; Sodium

Topics: Adult; Aged; Choroid Neoplasms; Cobalt Radioisotopes; Dose-Response Relationship, Radiation; Female; Humans; Light Coagulation; Macula Lutea; Male; Melanoma; Methods; Middle Aged; Phosphorus Radioisotopes; Radioisotopes; Radiotherapy; Radiotherapy Dosage; Rhodium; Ruthenium; Visual Acuity

Topics: Adult; Age Factors; Aged; Choroid Neoplasms; Ciliary Body; Diagnosis, Differential; Diagnostic Errors; Eye Diseases; Eye Neoplasms; Female; Glaucoma; Humans; Male; Melanoma; Middle Aged; Ophthalmia, Sympathetic; Phosphorus Radioisotopes; Radionuclide Imaging; Transillumination; Uvea

Topics: Animals; Gold Colloid, Radioactive; Humans; Injections, Intralymphatic; Iodine Radioisotopes; Lymphatic Metastasis; Melanoma; Phosphorus Radioisotopes; Radioisotopes

Topics: Adult; Female; Humans; Knee; Leg; Lymph Node Excision; Lymphatic Metastasis; Lymphography; Male; Melanoma; Middle Aged; Phosphorus Radioisotopes; Radionuclide Imaging; Skin Neoplasms

Topics: Eye Neoplasms; Humans; Melanoma; Phosphorus Radioisotopes; Transillumination; Ultrasonography

Topics: Gold Isotopes; Humans; Indium; Lymphatic Metastasis; Lymphography; Melanoma; Phosphorus Radioisotopes; Radionuclide Imaging; Skin Neoplasms

Topics: Humans; Melanoma; Neoplasms, Second Primary; Phosphorus; Phosphorus Radioisotopes; Phosphorus, Dietary

Topics: Humans; Melanoma; Phosphorus; Phosphorus Radioisotopes; Phosphorus, Dietary; Radioactivity

Topics: Humans; Melanoma; Melanoma, Cutaneous Malignant; Neoplasms; Phosphorus; Phosphorus Radioisotopes; Skin Neoplasms

Topics: Humans; Melanoma; Melanoma, Cutaneous Malignant; Phosphorus; Phosphorus Radioisotopes; Skin Neoplasms

Topics: Diagnosis, Differential; Humans; Melanoma; Nevus; Nevus, Pigmented; Phosphorus; Phosphorus Radioisotopes; Skin Neoplasms

Topics: Humans; Melanoma; Phosphorus; Phosphorus Radioisotopes; Phosphorus, Dietary; Skin

Topics: Choroid; Choroid Neoplasms; Humans; Melanoma; Phosphorus; Phosphorus Radioisotopes

Topics: Eye Neoplasms; Humans; Melanoma; Melanoma, Cutaneous Malignant; Phosphorus; Phosphorus Radioisotopes; Phosphorus, Dietary; Skin Neoplasms

Topics: Humans; Melanoma; Phosphorus; Phosphorus Radioisotopes; Phosphorus, Dietary

Topics: Eye Neoplasms; Humans; Melanoma; Phosphorus; Phosphorus Radioisotopes; Uveal Neoplasms

Topics: Diagnosis, Differential; Humans; Melanoma; Phosphorus; Phosphorus Radioisotopes; Phosphorus, Dietary; Radioactivity

Topics: Eye Neoplasms; Humans; Melanoma; Phosphorus; Phosphorus Radioisotopes; Radiometry; Scintillation Counting; Uveal Neoplasms

Topics: Humans; Melanoma; Nevus; Nevus, Pigmented; Phosphorus; Phosphorus Radioisotopes; Skin Neoplasms

Topics: Eye Neoplasms; Humans; Melanoma; Phosphorus; Phosphorus Radioisotopes

Topics: Eye; Eye Neoplasms; Humans; Melanoma; Neuroectodermal Tumors, Primitive, Peripheral; Phosphorus; Phosphorus Radioisotopes

Topics: Humans; Melanoma; Phosphorus; Phosphorus Radioisotopes

Topics: Choroid; Choroid Neoplasms; Humans; Melanoma; Phosphorus; Phosphorus Radioisotopes; Phosphorus, Dietary