Occult neoplasm in evisceration specimens

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dc.contributor.author Al-Shamsi, Hanan N.
dc.date.accessioned 2019-06-21T08:26:06Z
dc.date.available 2019-06-21T08:26:06Z
dc.date.copyright 2012 en_US
dc.date.issued 2019-06-21
dc.identifier.issn 1552-5783 en_US
dc.identifier.uri http://hdl.handle.net/10725/10884
dc.description.abstract Purpose: To report the incidental surprise of an occult tumor in evisceration specimens, and to stress the need for careful preoperative evaluation for establishing the optimal surgical procedure Methods: A retrospective, clinicopathological case series of three patients who underwent evisceration for a blind and painful eye that turned out to harbor an intraocular tumor. The cases were collected by searching the indexed ocular pathology registry over a period of 25 years at a single tertiary eye care center in the Kingdom of Saudi Arabia. The medical records were reviewed for patient demographic data, initial clinical diagnosis, imaging, indication for evisceration, histopathology, post-evisceration management, and final outcome Results: The three cases represent 0.2% of the indexed evisceration specimens. None of them was previously known to have an ocular tumor. The indication for evisceration was a blind and painful eye secondary to the clinical impression of endogenous endophthalmitis, trauma, and scleritis with recurrent scleral perforation. Histopathology of the eviscerated tissue disclosed malignant uveal melanoma (MM), anaplastic carcinoma of the non-pigmented ciliary epithelium (ACNPCE), and intraocular mucoepidermoid carcinoma (MEC) respectively. Preoperative ultrasonography was not performed in the latter case and failed to detect a tumor in the other two cases. Post-evisceration work-up was negative for metastasis in all cases. Two patients subsequently underwent enucleation with or without orbital radiation and one patient (MEC) had total exenteration. The patient with the MM died 10 years after enucleation but the cause was undocumented. The case with MEC was lost to follow-up and that with ACNPCE was free of local recurrence or systemic metastasis after eight years of follow-up post enucleation Conclusions: Blind painful eyes may rarely harbor an occult malignancy that may masquerade as other clinical entities. The presence of an intraocular tumor should be ruled out prior to evisceration of any blind eye particularly with opaque media. Imaging studies may be inconclusive due to disorganization of the intraocular contents. Enucleation may be a better option than evisceration in such cases and may at least spare the patient additional surgical procedures en_US
dc.language.iso en en_US
dc.title Occult neoplasm in evisceration specimens en_US
dc.type Article en_US
dc.description.version Published en_US
dc.author.school SOM en_US
dc.author.idnumber 201000154 en_US
dc.author.department N/A en_US
dc.description.embargo N/A en_US
dc.relation.journal Investigative Ophthalmology & Visual Science en_US
dc.journal.volume 53 en_US
dc.journal.issue 14 en_US
dc.keywords Tumors en_US
dc.keywords Oncology en_US
dc.keywords Pathology: human en_US
dc.identifier.ctation Al-Shamsi, N., Al-Katan H., & Ghazi, N. G. (2014). Occult neoplasm in evisceration specimens. Investigative Ophthalmology & Visual Science, 53(14) en_US
dc.author.email nicola.ghazi@lau.edu.lb en_US
dc.identifier.tou http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php en_US
dc.author.affiliation Lebanese American University en_US

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