Abstract
Fifty-six globes that had to be enucleated following ruthenium plaque therapy were examined histopathologically. These eyes account for 10% of all uveal melanomas treated at the University Eye Clinic Essen up until 1985. All but one revealed at least some supposedly viable tumor cells. The most prominent findings within the tumors were tumor cell necrosis, vacuolization and balloon cell degeneration, vascular obstruction and fibrosis of the tumor stroma with accumulation of pigmented macrophages. Tumor necrosis was complete or nearly complete in five cases. Tumor regression correlated with cell type and pigmentary characteristics of the tumor, with epithelioid and heavily pigmented tumor cells being more radiosensitive. Tumor regression was inhomogeneous, possibly due to polyclonality, with tumor cells of varying radiosensitivitiy, or due to patchy areas of vascular obliteration. Among other ocular structures, extensive subretinal gliosis, chorioretinal atrophy and scarring of the sclera within the field of radiation were observed. Scleral necrosis was present in only five cases and was limited to areas in which the tumor had infiltrated the deep scleral layers. The findings described were considered to reflect radiation injury rather than spontaneous tumor regression when compared to 70 control eyes that had been enucleated without prior treatment for uveal melanoma.
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Bujara K, Hallermann D (1984) Netzhaut-Aderhautnarbe nach Bestrahlung eines malignen Melanoms der Aderhaut mit dem Ruthenium-106-Applikator. Ophthalmologica 188:29–34
Char DH, Lonn LI, Margolis LW (1977) Complications of cobalt plaque therapy of choroidal melanomas. Am J Ophthalmol 84:536–541
Char DH, Crawford JB, Castro JR, Woodruff KH (1983) Failure of choroidal melanoma to respond to helium ion therapy. Arch Ophthalmol 101:236–241
Cleasby GW, Kutzscher BM (1985) Clinicopathologic report of successful cobalt 60 plaque therapy for choroidal melanoma. Am J Ophthalmol 100:828–830
Crawford JB, Char DH (1987) Histopathology of uveal melanomas treated with charged particle radiation. Ophthalmology 94:639–643
Domarus D von, Hallermann D (1979) Histologische Befunde nach Therapie mit dem Ru 106/Rh 106-Applikator. Ber Dtsch Ophthalmol Ges 76:185–188
Eichler C, Hertel H, Lommatzsch P, Fuhrmann P (1997) Echographische Befunde vor und nach β-Bestrahlung (106Ru/106Rh) von Aderhautmelanomen. Klin Monatsbi Augenheilkd 190:17–20
Ferry AP, Blair CJ, Gragoudas ES, Volk SC (1985) Pathologic examination of ciliary body melanoma treated with proton beam irradiation. Arch Ophthalmol 103:1849–1853
Goodman DF, Char DH, Crawford JB, Stone RD, Castro JR (1986) Uveal melanoma necrosis after Helium ion therapy. Am J Ophthalmol 101:643–645
Gragoudas ES, Seddon J, Goitein M, Suit HD, Blitzer P, Koehler A, Verhey L, Munzenrider J, Urie M (1985) Current results of proton beam irradiation of uveal melanomas. Ophthalmology 92:284–291
Grizzard WS, Torczynski E, Char DH (1984) Helium ion charged-particle therapy for choroidal melanoma. Histopathologic findings in a successfully treated case. Arch Ophthalmol 102:576–578
Kincaid MC, Folberg R, Torczynski E, Zakov ZN, Shore JW, Liu SJ, Planchard TA, Weingeist TA (1988) Complications after proton beam therapy for uveal malignant melanoma. A clinical and histopathologic study of five cases. Ophthalmology 95:982–991
Lommatzsch P (1977) Die therapeutische Anwendung von ionisierenden Strahlen in der Augenheilkunde. Thieme, Leipzig
Lommatzsch PK (1979) Radiotherapie der intraokularen Tumoren, insbesondere bei Aderhautmelanom. Klin Monatsbi Augenheilkd 174:948–958
Lommatzsch PK, Goder G (1965) Histologische Veränderungen an bestrahlten malignen intraokularen Tumoren. Graefe's Arch Clin Exp Ophthalmol 168:198–219
MacFaul PA, Morgan G (1977) Histopathological changes in malignant melanomas of the choroid after cobalt plaque therapy. Br J Ophthalmol 61:221–228
McLean IW, Foster WD, Zimmerman LE, Gamel IW (1983) Modification of Callender's classificiation of uveal melanomas at the armed forces institute of pathology. Am J Ophthalmol 96:502–509
Seddon JM, Gragoudas ES, Albert DM (1983) Ciliary body and choroidal melanomas treated by proton beam irradiation. Histopathologic study. Arch Ophthalmol 101:1402–1408
Shields CL, Shields JA, Karlsson U, Menduke H, Brady LW (1990) Enucleation after plaque radiotherapy for posterior uveal melanoma. Histopathologic findings. Ophthalmology 97:1665–1670
Zinn KM, Stein/Pokorny K, Jakobiec FA, Friedman AH, Gragoudas ES, Ritch R (1985) Proton-beam irradiated epithelioid cell melanoma of the ciliary body. Ophthalmology 88:1315–1321
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Messmer, E., Bornfeld, N., Foerster, M. et al. Histopathologic findings in eyes treated with a ruthenium plaque for uveal melanoma. Graefe's Arch Clin Exp Ophthalmol 230, 391–396 (1992). https://doi.org/10.1007/BF00165952
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DOI: https://doi.org/10.1007/BF00165952