phosphorus-radioisotopes and Uveal-Diseases

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

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

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

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

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