Choroidal melanoma with massive retinal fibrosis and spontaneous regression of retinal detachment.

An unusual case of choroidal malignant melanoma with heterochromia iridis, massive subretinal hemorrhage and fibrosis, spontaneously resolving retinal detachment, and subretinal seeding is reported. Clinical and pathological findings are presented and discussed. The unusual aspects of the case are further considered by Drs. Andrew Ferry and Mark Tso.     

Helium Ion Charged Particle Therapy for Choroidal Melanoma

Nine patients with choroidal melanomas were treated with helium ion charged particle irradiation. No patient demonstrated tumor enlargement, and most lesions followed for more than five months have demonstrated tumor shrinkage. The most effective method of choroidal melanoma management is unclear. Heavy charged particle irradiation may be more applicable and have less ocular morbidity associated with it in either radioactive plaques or photocoagulation.     

Cutaneous melanoma and its relation to melanoma of the uveal tract

Current tactics under study in the control of cutaneous melanoma may prove to be of benefit in management of uveal melanoma. These include precise staging at diagnosis and analysis of pathologic data correlated with the subsequent clinical course. The potential role of adjuvant chemotherapy and immunotherapy is discussed.     

The Differential Diagnosis of Posterior Uveal Melanoma

Two large studies from the Armed Forces Institute of Pathology (AFIP) have listed the various lesions which may clinically resemble malignant melanomas of the posterior uvea (pseudomelanomas). The studies from the AFIP were based upon histologic examination of eyes which were enucleated. The present study reports on 400 consecutive patients who were referred to an ocular oncology center with the diagnosis of posterior uveal melanoma but who proved, by clinical evaluation, rather than by enucleation, to have a pseudomelanoma. Although about 40 different conditions were found to simulate melanoma, the more commonly encountered ones included suspicious choroidal nevus (26.5%), disciform degeneration (12.5%), peripheral disciform degeneration (11%), congenital hypertrophy of the retinal pigment epithelium (9.5%), and choroidal, hemangioma (8%). The authors believe that this series provides the clinician with a differential diagnosis for posterior uveal melanomas which accurately reflects the clinical problem confronting ophthalmologists today.     

Excision of the large congenital melanocytic nevus facilitated by the use of the tissue expander

Large congenital melanocytic nevi both present a cosmetic problem and may predispose to the development of a melanoma. We present a series of three patients in whom the tissue expander was employed to facilitate a large excision with primary closure and excellent cosmesis.     

The utility of P388 leukemia compared to B16 melanoma and colon carcinoma 38 for in vivo screening of plant extracts

We compared the value of using two in vivo solid tumor murine screening models, the B16 Melanoma and Colon 38 carcinoma, to the use of in vivo P388 leukemia in the detection of active extracts and in the prioritization of weak P388 active extracts. We found that, among a diverse group of 82 cytotoxc plant extracts negative in the P388 assay in vivo, only one had activity in B16 melanoma or Colon 38 and, among a group of 99 botanically diverse P388-active extracts, none were active in either the B16 or Colon 38 models. We therefore conclude that the B16 and Colon 38 models in vivo are not useful for screening of crude extract and that, while the P388 leukemia may over-predict useful leads due to its high sensitivity, its use as a first screen for crude extracts does not appear to result in missing solid tumor actives.     

Metastatic Melanoma with Balloon Cell Changes: An Electron Microscopic Study

A case of metastatic balloon cell melanoma is presented. The balloon cells are ultrastructurally characterized by the presence of numerous cytoplasmic vacuoles and abnormal melanosomes, which confirm their melanocytic origin. The study supports the concept that the cytoplasmic vacuoles represent grossly dilated melanosomes. The value of electron microscopic examination is emphasized in order to distinguish these lesions from other malignant clear cell tumors.     

Radiosensitivity of nall human melanoma transplanted into nude mice: Repair,reoxygenation and dose fractionation

Split dose and fractionated γ-rays experiments have been performed on a human melanoma transplanted into nude mice using an in vitro colony assay. Repair of potentially lethal damage observed after a single dose of 20 Gy was found to no longer occur when 7 daily doses of 2.5 Gy were administered. In split-dose experiments, the increase in survival level probably can not be explained by repair of sublethal damage. When a single high dose of radiation is administered a certain reoxygenation is observed; however there is no reoxygenation when low radiation doses are delivered daily.     

Nondermatoscopic digital imaging of pigmented lesions

Background/aims: Pigmented lesions are often difficult to evaluate clinically. Improvement of diagnostic accuracy by dermatoscopy has attracted much interet. With advanced digital imaging measurement of assymmetry, border irregularity and relative color as well as texture characteristics, lesional depth and changes in lesional area are now possible, the object of this review is to conclude the present status of these techniques and their potential.
Conclusions: Digital imaging of pigmented lesions to this date include acquiring and storing of images, quantification of clinical features including asymmetry, and teledermatology with transfer of images. Predicted uses include malignancy evaluation, delineation of depth of invasion and the development of large collections of pigment lesions observations. The field is rapidly expanding. As of 1994, it is unknown what role digital imaging will ultimately play in clinical dermatology.     

Hyaluronidase significantly enhances the efficacy of regional vinblastine chemotherapy of malignant melanoma

The regional chemotherapy of the human malignant melanomas (SK-MEL-2, -3, -5, -24) implanted in NMRInu/nu mice with a combination of the hyaluronic-acid-cleaving enzyme hyaluronidase (HYase) and vinblastine is a very effective therapeutic procedure. In three out of four melanoma models (SK-MEL-2,-3, -5) the weekly peritumoral administration of high-dose HYase (100 000 IU/kg) 4 h prior to the injection of 0.3 mg/kg vinblastine in the vicinity of the tumor (seven weekly therapeutic cycles) caused marked antitumor effects, while HYase and vinblastine were inactive when given alone. The pretreatment with HYase, which is well tolerated by the test animals, prevented local inflammation reactions commonly seen after subcutaneous vinblastine administration. Tumor growth and metastatic behavior of the melanomas used were neither increased nor reduced by HYase after peritumoral administration without subsequent vinblastine injection. The curative activity of the regional chemotherapy with HYase/vinblastine could be demonstrated on the SK-Mel-3 melanoma. After an observation time of 18 weeks tumor cells could no longer be detected in the subcutaneous region of the former lesion. Only macrophages, which had abundantly incorporated melanin, gave evidence of previously growing tumors. In contrast to the controls, no metastases could be observed in the axillary lymph nodes of the test animals.Abbreviations HA hyaluronic acid - T/C 100 X [median tumor area of therapy group (mm²)]/[median tumor area of control group (mm²)] - n number of animals per group