Occult neoplasm in evisceration specimens

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 f...

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Main Author: Al-Shamsi, Hanan N. (author)
Format: article
Published: 2012
Online Access:http://hdl.handle.net/10725/10884
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
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author Al-Shamsi, Hanan N.
author_facet Al-Shamsi, Hanan N.
author_role author
dc.creator.none.fl_str_mv Al-Shamsi, Hanan N.
dc.date.none.fl_str_mv 2012
2019-06-21T08:26:06Z
2019-06-21T08:26:06Z
2019-06-21
dc.identifier.none.fl_str_mv 1552-5783
http://hdl.handle.net/10725/10884
Al-Shamsi, N., Al-Katan H., & Ghazi, N. G. (2014). Occult neoplasm in evisceration specimens. Investigative Ophthalmology & Visual Science, 53(14)
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
dc.language.none.fl_str_mv en
dc.relation.none.fl_str_mv Investigative Ophthalmology & Visual Science
dc.rights.*.fl_str_mv info:eu-repo/semantics/openAccess
dc.title.none.fl_str_mv Occult neoplasm in evisceration specimens
dc.type.none.fl_str_mv Article
info:eu-repo/semantics/publishedVersion
info:eu-repo/semantics/article
description 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
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identifier_str_mv 1552-5783
Al-Shamsi, N., Al-Katan H., & Ghazi, N. G. (2014). Occult neoplasm in evisceration specimens. Investigative Ophthalmology & Visual Science, 53(14)
language_invalid_str_mv en
network_acronym_str LAURepo
network_name_str Lebanese American University repository
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spelling Occult neoplasm in evisceration specimensAl-Shamsi, Hanan N.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 proceduresPublishedN/A2019-06-21T08:26:06Z2019-06-21T08:26:06Z20122019-06-21Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article1552-5783http://hdl.handle.net/10725/10884Al-Shamsi, N., Al-Katan H., & Ghazi, N. G. (2014). Occult neoplasm in evisceration specimens. Investigative Ophthalmology & Visual Science, 53(14)http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.phpenInvestigative Ophthalmology & Visual Scienceinfo:eu-repo/semantics/openAccessoai:laur.lau.edu.lb:10725/108842021-03-19T10:45:30Z
spellingShingle Occult neoplasm in evisceration specimens
Al-Shamsi, Hanan N.
status_str publishedVersion
title Occult neoplasm in evisceration specimens
title_full Occult neoplasm in evisceration specimens
title_fullStr Occult neoplasm in evisceration specimens
title_full_unstemmed Occult neoplasm in evisceration specimens
title_short Occult neoplasm in evisceration specimens
title_sort Occult neoplasm in evisceration specimens
url http://hdl.handle.net/10725/10884
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php