Abstract :
Purpoe: To decribe the principal hitopathologic finding in a erie of 1,527 globe with uveal melanoma and the relationhip of thee finding to each other.
Method: All eye enucleated in the Collaborative Ocular Melanoma tudy (COM) were examined independently by three ophthalmic pathologit and the finding recorded on a data form. A compoite of finding wa obtained after adjudication.
Reult: The diagnoi wa choroidal melanoma in 1,527 (99.7%) of 1,532 cae examined. Midiagnoe were metatatic adenocarcinoma (four) and hemangioma (one). pindle cell (9.0%), mixed cell (86.0%), and epithelioid cell (5.0%) type were oberved. Medium tumor were located more poteriorly than large tumor. Coniderable local invaion wa een: rupture of Bruch’ membrane (87.7%), invaion of the retina (49.1%), tumor cell in the vitreou (25.2%), vortex vein invaion (8.9%), invaion of tumor veel by tumor cell (13.8%), and invaion into emiary canal (55.0%). Overall, 81.1% demontrated local invaion, excluding rupture of Bruch’ membrane. cleral invaion wa preent in 55.7% of eye, and extracleral extenion wa preent in 8.2%. Mitotic activity wa ignificantly reduced in eye that had received preenucleation radiation treatment (P < .001). The number of macrophage in the tumor increaed with increaed pigmentation (P < .001) and increaed necroi (P < .01).
Concluion: The accuracy of diagnoi in the COM i high, with hitopathologic confirmation of the diagnoi at 99.7%. Extenive local invaion of the tumor wa een. Preenucleation irradiation ignificantly reduced the number of mitotic figure. An aociation wa found regarding the preence of macrophage, the level of pigmentation, and degree of necroi.
