Clinical pathology analysis of 30 patients with mushroom shaped uveal melanoma_Chinese Journal of Ocular Fundus Diseases

Authors：

Zhang Ju ¹ ,  Wei Wenbin ¹ , Li Bin ² , Xu Xiaolin ²

1. Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing 100730, China;
2. Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Institute of Ophthalmology, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing 100730, China;

Corresponding author：

Wei Wenbin, Email: weiwenbintr@163.com

Keywords：

Uveal neoplasma/pathology; Melanoma/pathology

DOI：

10.3760/cma.j.issn.1005-1015.2020.02.008

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Objective To analyze the clinical pathological features of mushroom shaped uveal melanoma.Methods Retrospective clinical study. From June 2001 to Aprilh 2013, pathological sections from 102 eyes of 102 patients with uveal melanoma diagnosed in Beijing Tongren Eye Center were included in the study. The sections were divided into group A (mushroom shaped uveal melanoma, 30 eyes) and group B (flat, hemisperical and spherical uveal melanoma, 72 eyes). The height-to-base ratio was calculated. The tumors size was divided into small, medium and large according to the standards of American Multicentre Study of Ocular Melanoma. The tumor cell type was divided into spindle, epithelioid, mixed and others by Improved Callender taxonomy. Motic Med 6.0 software was used to collect and measure the images. The retinal thinning rate of group A and B was compared by χ² test.Results In group A, large size in 19 eyes (63.3%), medium size in 11 eyes (36.7%). In group B, large size in 49 eyes (68.1%), medium size in 16 eyes (22.%), small size in 7 eyes (9.7%). In group A and B, the average tumor base diameter were 14.2±5.1 mm and 18.7±6.4 mm, respectively; the average tumor height were 10.0±2.1 mm and 7.6±3.9, respectively; the height-to-base ratio were 0.77±0.29 and 0.44±0.28, respectively. In group A, spindle type in 24 eyes (80.0%), epithelioid type in 1 eye (3.3%), mixed type in 5 eyes (16.7%). In group B, spindle type in 52 eyes (72.2%), epithelioid type in 5 eyes (6.9%), mixed type in 11 eyes (15.3%), and others in 4 eyes (5.6%). The proportion of retinal thinning were 73.3% (22 eyes) and 29.2% (21 eyes) in group A and B, respectively. The difference in the proportion of retinal thinning between group A and B was significant (χ²=16.94, P=0.000).Conclusion The height of the tumor increased rapidly and the retinal thinning rate is high in mushroom shaped uveal melanoma.

Citation： Zhang Ju, Wei Wenbin, Li Bin, Xu Xiaolin. Clinical pathology analysis of 30 patients with mushroom shaped uveal melanoma. Chinese Journal of Ocular Fundus Diseases, 2020, 36(2): 127-130. doi: 10.3760/cma.j.issn.1005-1015.2020.02.008 Copy

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4.	王庆平, 徐格致, 陈倩. 脉络膜黑色素瘤的B型超声和病理检查分析[J]. 中华实验眼科杂志, 2005, 23(2): 207-209. DOI: 10.3760/cma.j.issn.2095-0160.2005.02.028.Wang QP, Xu GZ, Chen Q. B-ultrasonography and pathologic analysis of choroidal melanoma[J]. Chin J Exp Ophthalmol, 2005, 23(2): 207-209. DOI: 10.3760/cma.j.issn.2095-0160.2005.02.028.
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8.	王凤华, 李彬, 李辽青, 等. 脉络膜黑色素瘤微血管密度与其临床组织病理学预后指标关系的探讨[J]. 中华实验眼科杂志, 2004, 22(1): 17-20. DOI: 10.3760/cma.j.issn.2095-0160.2004.01.005.Wang FH, Li B, Li LQ, et al. Correlation of tumor microvessle density with clinicopathologic prognostic parameters in choroidal melanoma[J]. Chin J Exp Ophthalmol, 2004, 22(1): 17-20. DOI: 10.3760/cma.j.issn.2095-0160.2004.01.005.
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10.	Weidner N. Intratumor microvessel density as a prognostic factor in cancer[J]. Am J Pathol, 1995, 147(1): 9-19.
11.	Kaiserman I, Amer R, Kaiserman N, et al. Ultrasonographic tissue characteristics of mushroom-shaped uveal melanoma[J]. Curr Eye Res, 2005, 30(3): 171-177. DOI: 10.1080/02713680490908634.
12.	张举, 顼晓琳, 李彬, 等. 葡萄膜黑色素瘤瘤体生长对视网膜和巩膜浸润的影响[J]. 中华眼科杂志, 2016, 52(10): 749-754. DOI: 10.3760/cma.j.issn.0412-4081.2016.10.007.Zhang J, Xu XL, Li B, et al. Characteristics of retinal and scleral infiltration in uveal melanoma[J]. Chin J Ophthalmol, 2016, 52(10): 749-754. DOI: 10.3760/cma.j.issn.0412-4081.2016.10.007.
13.	Foss AJE, Alexander RA, Jefferies LW, et al. Microvessel count predicts survival in uveal melanoma[J]. Cancer Res, 1996, 56(13): 2900-2903.
14.	Makitie T, Summanen P, Tarkkanen A, et al. Microvascular density in predicting survival of patients with choroidal and ciliary body melanoma[J]. Invest Ophthalmol Vis Sci, 1999, 40(11): 2471-2480.
15.	Chen Y, Lu X, Montoya-Durango DE, et al. ZEB1 regulates multiple oncogenic components involved in uveal melanoma progression[J]. Sci Rep, 2017, 7(1): 45. DOI: 10.1038/s41598-017-00079-x.
16.	Cheng G, Tse J, Jain RK, et al. Micro-environmental mechanical stress controls tumor spheroid size and morphology by suppressing proliferation and inducing apoptosis in cancer cells[J/OL]. PLoS One, 2009, 4(2): 4632. https://doi.org/10.1371/journal.pone.0004632. DOI: 10.1371/journal.pone.0004632.
17.	朱瑞琳, 魏文斌, 李彬, 等. 葡萄膜黑色素瘤临床病理特征与预后的相关因素分析[J]. 中华眼底病杂志, 2011, 27(5): 435-439. DOI: 10.3760/cma.j.issn.1005-1015.2011.05.008.Zhu RL, Wei WB, Li B, et al. The relationship between the prognosis and the clinical and pathological features of uveal melanomas[J]. Chin J Ocul Fundus Dis, 2011, 27(5): 435-439. DOI: 10.3760/cma.j.issn.1005-1015.2011.05.008.
18.	Shields CL, Kaliki S, Furuta M, et al. Clinical spectrum and prognosis of uveal melanoma based on age at presentation in 8, 033 cases[J]. Retina, 2012, 32(7): 1363-1372. DOI: 10.1097/IAE.0b013e31824d09a8.
19.	Richtig E, Langmann G, Müllner K, et al. Calculated tumour volume as a prognostic parameter for survival in choroidal melanomas[J]. Eye, 2004, 18(6): 619-623. DOI: 10.1038/sj.eye.6700720.
20.	赵志娟, 何健, 丁素玲. 26例脉络膜黑色素瘤临床和病理误诊分析[J]. 中国医学工程, 2014, 22(4): 49-50.Zhao ZJ, He J, Ding SL. Clinical and pathological misdiagnosis of choroidal melanoma in 26 cases[J]. China Medical Engineering, 2014, 22(4): 49-50.

1. 陈青华, 王振常, 李彬, 等. 葡萄膜黑色素瘤MRI及动态增强研究[J]. 当代医学, 2009, 15(20): 12-16. DOI: 10.3969/j.issn.1009-4393.2009.20.003.Chen QH, Wang ZC, Li B, et al. The study of plane and dynamic contrast-en-hanced MRI in uveal melanoma[J]. Contemporary Medicine, 2009, 15(20): 12-16. DOI: 10.3969/j.issn.1009-4393.2009.20.003.
2. Shields CL, Kaliki S, Furuta M, et al. American joint committee on cancer classification of uveal melanoma (anatomic stage) predicts prognosis in 7, 731 patients:the 2013 Zimmerman lecture[J]. Ophthalmology, 2015, 122(6): 1180-1186. DOI: 10.1016/j.ophtha.2015.01.026.
3. Diener-West M, Reynolds SM, Agugiaro DJ, et al. Screening for metastasis from choroidal melanoma: the collaborative ocular melanoma study group report 23[J]. J Clin Oncol, 2004, 22(12): 2438-2444. DOI: 10.1200/JCO.2004.08.194.
4. 王庆平, 徐格致, 陈倩. 脉络膜黑色素瘤的B型超声和病理检查分析[J]. 中华实验眼科杂志, 2005, 23(2): 207-209. DOI: 10.3760/cma.j.issn.2095-0160.2005.02.028.Wang QP, Xu GZ, Chen Q. B-ultrasonography and pathologic analysis of choroidal melanoma[J]. Chin J Exp Ophthalmol, 2005, 23(2): 207-209. DOI: 10.3760/cma.j.issn.2095-0160.2005.02.028.
5. Sobottka B, Kreissig I. Ultrasonography of metastases and melanomas of the choroid[J]. Curr Opin Ophthalmol, 1999, 10(3): 164-167. DOI: 10.1097/00055735-199906000-00002.
6. Zimmerman LE, Sobin LH. Histologic typing of tumors of the eye and its adnexa//Zimmerman LE, Sobin LH. International histological classification of tumor[M]. Geneva: World Health Organization, 1980: 112-116.
7. Ayres B, Bretana ME, Dubovy S, et al. Mushroom-shaped secondary vasoproliferative tumor[J]. Ophthalmic Surg Lasers Imaging, 2012, 43: 104-106. DOI: 10.3928/15428877-20120927-03.
8. 王凤华, 李彬, 李辽青, 等. 脉络膜黑色素瘤微血管密度与其临床组织病理学预后指标关系的探讨[J]. 中华实验眼科杂志, 2004, 22(1): 17-20. DOI: 10.3760/cma.j.issn.2095-0160.2004.01.005.Wang FH, Li B, Li LQ, et al. Correlation of tumor microvessle density with clinicopathologic prognostic parameters in choroidal melanoma[J]. Chin J Exp Ophthalmol, 2004, 22(1): 17-20. DOI: 10.3760/cma.j.issn.2095-0160.2004.01.005.
9. 刘雯, 李彬, 高飞, 等. 脉络膜黑色素瘤微循环模式与其组织病理学关系的分析[J]. 中华实用眼科杂志, 2012, 30(5): 414-444. DOI: 10.3760/cma.j.issn.2095-0160.2012.05.013.Liu W, Li B, Gao F, et al. Relationship of microcirculation pattern and histopathologic factors in choroidal melanoma[J]. Chin J Exp Ophthalmol, 2012, 30(5): 414-444. DOI: 10.3760/cma.j.issn.2095-0160.2012.05.013.
10. Weidner N. Intratumor microvessel density as a prognostic factor in cancer[J]. Am J Pathol, 1995, 147(1): 9-19.
11. Kaiserman I, Amer R, Kaiserman N, et al. Ultrasonographic tissue characteristics of mushroom-shaped uveal melanoma[J]. Curr Eye Res, 2005, 30(3): 171-177. DOI: 10.1080/02713680490908634.
12. 张举, 顼晓琳, 李彬, 等. 葡萄膜黑色素瘤瘤体生长对视网膜和巩膜浸润的影响[J]. 中华眼科杂志, 2016, 52(10): 749-754. DOI: 10.3760/cma.j.issn.0412-4081.2016.10.007.Zhang J, Xu XL, Li B, et al. Characteristics of retinal and scleral infiltration in uveal melanoma[J]. Chin J Ophthalmol, 2016, 52(10): 749-754. DOI: 10.3760/cma.j.issn.0412-4081.2016.10.007.
13. Foss AJE, Alexander RA, Jefferies LW, et al. Microvessel count predicts survival in uveal melanoma[J]. Cancer Res, 1996, 56(13): 2900-2903.
14. Makitie T, Summanen P, Tarkkanen A, et al. Microvascular density in predicting survival of patients with choroidal and ciliary body melanoma[J]. Invest Ophthalmol Vis Sci, 1999, 40(11): 2471-2480.
15. Chen Y, Lu X, Montoya-Durango DE, et al. ZEB1 regulates multiple oncogenic components involved in uveal melanoma progression[J]. Sci Rep, 2017, 7(1): 45. DOI: 10.1038/s41598-017-00079-x.
16. Cheng G, Tse J, Jain RK, et al. Micro-environmental mechanical stress controls tumor spheroid size and morphology by suppressing proliferation and inducing apoptosis in cancer cells[J/OL]. PLoS One, 2009, 4(2): 4632. https://doi.org/10.1371/journal.pone.0004632. DOI: 10.1371/journal.pone.0004632.
17. 朱瑞琳, 魏文斌, 李彬, 等. 葡萄膜黑色素瘤临床病理特征与预后的相关因素分析[J]. 中华眼底病杂志, 2011, 27(5): 435-439. DOI: 10.3760/cma.j.issn.1005-1015.2011.05.008.Zhu RL, Wei WB, Li B, et al. The relationship between the prognosis and the clinical and pathological features of uveal melanomas[J]. Chin J Ocul Fundus Dis, 2011, 27(5): 435-439. DOI: 10.3760/cma.j.issn.1005-1015.2011.05.008.
18. Shields CL, Kaliki S, Furuta M, et al. Clinical spectrum and prognosis of uveal melanoma based on age at presentation in 8, 033 cases[J]. Retina, 2012, 32(7): 1363-1372. DOI: 10.1097/IAE.0b013e31824d09a8.
19. Richtig E, Langmann G, Müllner K, et al. Calculated tumour volume as a prognostic parameter for survival in choroidal melanomas[J]. Eye, 2004, 18(6): 619-623. DOI: 10.1038/sj.eye.6700720.
20. 赵志娟, 何健, 丁素玲. 26例脉络膜黑色素瘤临床和病理误诊分析[J]. 中国医学工程, 2014, 22(4): 49-50.Zhao ZJ, He J, Ding SL. Clinical and pathological misdiagnosis of choroidal melanoma in 26 cases[J]. China Medical Engineering, 2014, 22(4): 49-50.

Chinese Journal of Ocular Fundus Diseases

Clinical pathology analysis of 30 patients with mushroom shaped uveal melanoma

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