1/36. indocyanine green angiography of optic nerve head melanocytoma.PURPOSE: To determine the features of fluorescein and indocyanine green angiography of melanocytoma. methods: Fluorescein and indocyanine green angiography is used to assess an optic nerve head melanocytoma in a 45-year-old female. RESULTS: fluorescein angiography revealed increased vascularity on the surface, with staining around the lesion in the late stages. The lesion was hypofluorescent in all stages of indocyanine green angiography. CONCLUSIONS: indocyanine green angiography is helpful in identifying the benign nature of the lesion by showing hypofluorescence, indicating lack of vascularity in the tumor.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
2/36. Malignant transformation of an optic disk melanocytoma.PURPOSE: To report a case of malignant transformation of an optic disk melanocytoma with a second melanocytoma in the ciliary body. methods: Clinical data including visual acuity, visual fields, color fundus photographs, fluorescein angiogram, and ultrasonogram and histopathologic studies of this case were reviewed. RESULTS: The right eye of a 65-year-old white woman was diagnosed with melanocytoma of the optic nerve. Four years later, the tumor became significantly larger. The best-corrected visual acuity declined from 20/40 to counting fingers and the size of the tumor increased fourfold in 2 years. The right globe was enucleated. Histopathologic studies demonstrated moderately pigmented spindle-B malignant melanoma cells adjacent to and within a population of large, polyhedral, heavily pigmented melanocytoma cells that extended to the lamina cribrosa and optic nerve. There was also a deeply pigmented melanocytoma in the ciliary body. CONCLUSION: This is a rare case of malignant melanoma transformed from an optic disk melanocytoma. Periodic follow-up of the patient with optic disk melanocytoma is necessary.- - - - - - - - - - ranking = 0.4keywords = nerve (Clic here for more details about this article) |
3/36. Melanocytoma of the left optic nerve head and right retrobulbar optic neuropathy compressed by a tuberculum sellae meningioma.A 40-year-old woman had a highly pigmented, slightly elevated tumor on the left optic disc. She had no visual disturbance in the left eye. The tumor was stationary for 5 years. At age 45 years, she complained of decreased visual acuity in the right eye. magnetic resonance imaging showed a right-shifted homogeneous lesion at the tuberculum sellae. Histopathologic study of the excised lesion revealed interlacing bundles of spindle-shaped fibroblast-like cells with whorl formation. We believe that a relationship between melanocytoma of the optic nerve head and a tuberculum sellae meningioma may exist rather than a chance occurrence, as previously suggested by others.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
4/36. Optical coherence tomography of melanocytoma.PURPOSE: To evaluate the use of optical coherence tomography in differentiating between melanocytoma and choroidal melanoma. methods: case reports. Three consecutive patients with melanocytoma were scanned using optical coherence tomography. RESULTS: Optical coherence tomography showed lesions with a high reflectance signal anteriorly and optical shadowing behind, corresponding to the melanocytomas. The high signal was continuous with the retinal nerve fiber layer, consistent with known growth patterns of melanocytoma. CONCLUSION: Optical coherence tomography may be useful in differentiating melanocytoma from choroidal melanocytic lesions.- - - - - - - - - - ranking = 0.2keywords = nerve (Clic here for more details about this article) |
5/36. Central retinal vascular obstruction secondary to melanocytoma of the optic disc.A 35-year-old black man developed abrupt visual loss in his left eye. Ophthalmic examination revealed a deeply pigmented mass obscuring the optic disc, hemorrhagic retinopathy, and signs of central retinal vascular obstruction. fluorescein angiography disclosed sluggish filling of the retinal blood vessels; ultrasonography disclosed an acoustically solid mass in the optic nerve head. Cytopathologic findings of a fine needle aspiration biopsy specimen demonstrated probable benign tumor cells, but melanoma could not be excluded. Histopathologic findings in the enucleated eye revealed a large, necrotic melanocytoma of the optic disc and hemorrhagic necrosis of the retina secondary to obstruction of the central retinal artery and vein. Melanocytoma of the optic nerve can undergo spontaneous necrosis and induce central retinal vascular obstruction. Abrupt visual loss in a patient with a melanocytoma does not necessarily imply malignant transformation.- - - - - - - - - - ranking = 0.4keywords = nerve (Clic here for more details about this article) |
6/36. Late normalization of melanocytomalytic intraocular pressure elevation following excision of iris melanocytoma.BACKGROUND: Melanocytoma of the iris is a rare tumor which may sometimes undergo necrosis that could result in elevated intraocular pressure through pigment dispersion. Only nine similar patients have been previously reported. methods: A 27-year-old woman presented with a dark brown iris stromal mass located between the 4 and 8 o'clock positions in the inferior quadrant. Her left visual acuity was 20/60. The tumor encroached on the lens and caused focal cataract. There was massive pigmented debris over the iridocorneal angle and the intraocular pressure was 42 mmHg. RESULTS: Fine needle aspiration biopsy did not suggest malignancy. A wide sector iridectomy was performed and histopathological examination of the lesion revealed melanocytoma of the iris. There was no ciliary body involvement. In the postoperative period, intraocular pressure, which persisted in the mid-twenties, was successfully lowered with topical dorzolamide and betaxolol drops. These drugs were continued for 2 years while the angle pigmentation gradually disappeared. There has been no documented glaucomatous damage to the optic nerve and visual fields. A year after the cessation of the drops, the left intraocular pressure stabilized and did not rise above 15 mmHg. Her left visual acuity remained 20/25. CONCLUSION: In contrast to previously reported cases, the normalization of intraocular pressure in this patient took 26 months, a period that could be associated with the self-clearing process of pigment from the iridocorneal angle. Close follow-up with medical treatment averted a pressure lowering surgical procedure in this case.- - - - - - - - - - ranking = 0.2keywords = nerve (Clic here for more details about this article) |
7/36. rhabdomyosarcoma arising in a congenital melanocytic nevus.A variety of malignancies have been reported to arise within congenital melanocytic nevi, most commonly malignant melanoma, but rarely rhabdomyosarcoma, liposarcoma, and malignant peripheral nerve sheath tumor as well. There have been only three documented cases of rhabdomyosarcoma arising within congenital melanocytic nevi: two embryonal rhabdomyosarcomas and one mixed liposarcoma and rhabdomyosarcoma. One of these cases was also associated with neurocutaneous melanosis. We report a fourth case of rhabdomyosarcoma originating from a congenital melanocytic nevus. A 4-year-old girl presented with a large ulcerated nodule that developed within a hairy congenital nevus on her left gluteal and sacral regions. Her parents refused postoperative adjuvant therapy, and she died 13 months after surgical excision. Histologic sections showed a lesion with two distinct components. There was an expansile proliferation of pleomorphic cells within a fibromyxoid stroma. The neoplastic cells were spindled, and some had abundant eosinophilic globular cytoplasm with occasional cross-striations characteristic of rhabdomyoblasts. They strongly expressed desmin and myoglobin and were negative for S-100 protein and HMB-45. The tumor merged with an adjacent congenital melanocytic nevus characterized by a proliferation of uniform nonatypical melanocytes. The finding of both rhabdomyoblastic and melanocytic differentiation within the same lesion lends support to the hypothesis of their derivation from common pluripotential stem cells or neural crest cells.- - - - - - - - - - ranking = 0.2keywords = nerve (Clic here for more details about this article) |
8/36. Intradermal melanocytic nevus with prominent schwannian differentiation.Features of peripheral nerve sheath differentiation such as neuroid cords, nerve corpuscles, fascicle-like structures, and, exceptionally, palisading have been reported in melanocytic nevi. We report an intradermal melanocytic nevus with prominent Verocay-like bodies. The upper portion of the neoplasm was composed of typical round intradermal nevus cells, many of which were pigmented. Within the deeper portion, there was a nonpigmented spindle cell proliferation with prominent Verocay bodies, simulating a neurilemmoma. Typical nevus nests merged with neurilemmoma-like areas. The entire lesion stained positively for S-100 and Mart-1 proteins and negatively for HMB-45 stain. Diffuse Mart-1 positivity excluded a collision of a melanocytic lesion with a neurilemmoma. The histopathologic features of this nevus further support a close relation between nevus cells and schwann cells.- - - - - - - - - - ranking = 0.4keywords = nerve (Clic here for more details about this article) |
9/36. Melanocytoma inducing compressive optic neuropathy: the ocular morbidity potential of an otherwise invariably benign lesion.PURPOSE: The purpose of this article is to document a case of melanocytoma of the optic nerve head inducing compressive optic neuropathy; to provide a summarized clinical review; and to reflect on the potential ocular morbidity aspects of this relatively benign insult. methods: We present a case report of a 32-year-old Hispanic woman with constant esotropia, inert tractional Toxacara granuloma in the right eye, and a jet-black lesion engulfing the left eye optic nerve head, with accompanying disk edema. RESULTS: A diagnosis of melanocytoma of the optic nerve with secondary compressive optic neuropathy was made on the basis of the clinical presentation. Patient education and quarterly follow-up visits to monitor the lesion were the recommended management. CONCLUSION: Although optic nerve head melanocytoma can be considered benign, it has the underlying potential to promote ocular morbidity. Our case report highlights the potential impact of melanocytoma on optic nerve head anatomy. The potential for even subtle changes in the visual fields from this condition becomes significant in a monocular patient. This is exemplified in this case, by the presence of a co-existing Toxacara granuloma and related amblyopia in the contralateral eye.- - - - - - - - - - ranking = 1keywords = nerve (Clic here for more details about this article) |
10/36. Organized vitreous hemorrhage masquerading as an optic disc melanocytoma.PURPOSE: To present a case of organized vitreous hemorrhage masquerading an optic disc melanocytoma. DISCUSSION: optic nerve head melanocytoma is a benign slightly pigmented lesion arising from the edge of the disc presenting with a filed defect. Pigmented nature of the lesion in question due to presence of haemosidrin laden macrophages led a diagnostic dilemma. Trans vitreal biopsy confirmed the diagnosis. CONCLUSIONS: Althought classical in presentation organized blood clots can masquerade a number of lesions including a melanocytoma as in the present scenario.- - - - - - - - - - ranking = 0.2keywords = nerve (Clic here for more details about this article) |
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