ANALYSIS OF THE PREVALENCE OF METASTATIC CHOROIDAL LESIONS

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Abstract

Background: Ophthalmologists have a  low oncological vigilance, while oncologists are insufficiently aware of the incidence of choroidal metastases. Aim: To estimate incidence of choroidal metastases in Russia and to analyze prevalence of tumors metastasizing to the choroid. Materials and methods: Based on the literature, we empirically calculated the incidence of choroidal metastases in Russia. Our own study involved 70 patients (56  female and 14  male) with choroidal metastases. All patients underwent complete ophthalmic and physical examination. Results: In Russia, the estimated number of new choroid metastases cases in 2014 was 5561, which is 6-fold higher than the estimated number of primary uveal melanomas. Among 70  patients with choroidal metastases, the primary tumor site was known in 58  (82.8%) patients, whereas in 12 (17.2%) patients with choroidal metastases had an unknown primary tumor. The vast majority of primary tumors were carcinomas (53 patients, 91.4%); 4 patients (6.9%) had melanomas, and one (1.7%) had acute leukemia. Choroidal metastases were the first sign of advanced malignancy in 34 (48.6%) patients. The time periods from the date of diagnosis of the primary tumor to the date of diagnosis of intraocular metastatic tumors varied from  0 to 192  months. Conclusion: Empirical calculation shows that the incidence of choroidal metastasis in the adults is higher than that of the uveal melanoma. Due to the high prevalence of choroidal metastases, they should always be kept in mind if an intraocular neoplasm is detected. When choosing a diagnostic algorithm, special attention should be paid to the cancer history of the patient. The necessity of life-long ophthalmologic screening of patients with malignant neoplasms is hereby justified.

About the authors

Ya. V. Parmon

Moscow Helmholtz Research Institute of Eye Diseases; 14/19 Sadovaya-Chernogryazskaya ul., Moscow, 105062, Russian Federation

Author for correspondence.
Email: yanina.parmon@gmail.com
MD, Head of Department of Ophthalmology and Treatment of Ocular Cancer Russian Federation

S. V. Saakyan

Moscow Helmholtz Research Institute of Eye Diseases; 14/19 Sadovaya-Chernogryazskaya ul., Moscow, 105062, Russian Federation

Email: yanina.parmon@gmail.com
MD, PhD, Professor, Head of Department of Ophthalmic Oncology and Radiology Russian Federation

References

  1. Augsburger JJ, Guthoff R. Metastatic cancer to the eye. In: Yanoff M, Duker JS, editors. Ophthalmology. 3rd ed. Elsevier; 2009. p. 906–10.
  2. De Potter P. Ocular manifestations of cancer. Curr Opin Ophthalmol. 1998;9(6): 100–4.
  3. Kreusel KM, Bechrakis NE, Wiegel T, Krause L, Foerster MH. Incidence and clinical characteristics of symptomatic choroidal metastasis from lung cancer. Acta Ophthalmol. 2008;86(5): 515–9. doi: 10.1111/j.1600-0420.2007.01081.x.
  4. Shields JA. Metastatic tumors to the uvea. Int Ophthalmol Clin. 1993;33(3): 155–61.
  5. Eliassi-Rad B, Albert DM, Green WR. Frequency of ocular metastases in patients dying of cancer in eye bank populations. Br J Ophthalmol. 1996;80(2): 125–8. doi: 10.1136/bjo.80.2.125.
  6. Гришина ЕЕ. Метастазы солидных опухолей в орбиту. Трудности диагностики (разбор клинических случаев). Альманах клинической медицины. 2015;41:103–9. doi: 10.18786/2072-0505-2015-41-103-109.
  7. Volpe NJ, Albert DM. Metastases to the uvea. In: Albert DM, Jakobiec FA, editors. Principles and Practices of Ophthalmology. Philadelphia, PA: WB Saunders Co; 1995. p. 3260–70.
  8. Бровкина АФ, ред. Офтальмоонкология. М.: Медицина; 2002. 424 с.
  9. Каприн АД, Старинский ВВ, Петрова ГВ, ред. Состояние онкологической помощи населению России в 2014 году. М.: МНИОИ им. П.А. Герцена – филиал ФГБУ «НМИРЦ» Минздрава России; 2015. 236 c.
  10. Нероев ВВ, Саакян СВ, Амирян АГ, Пармон ЯВ, Кружкова ГВ. Дифференциально-диагностические критерии увеальной меланомы и метастатических опухолей хориоидеи по данным комплексного высокочастотного ультразвукового сканирования. Российский офтальмологический журнал. 2015;8(2): 5–13.
  11. Саакян СВ, Нероев ВВ, Юровская НН, Рябина МВ, Мякошина ЕБ, Пармон ЯВ. Оптическая когерентная томография опухолеассоциированных изменений сетчатки при новообразованиях хориоидеи. Российский офтальмологический журнал. 2009;2(2): 35–41.
  12. Пармон ЯВ, Саакян СВ. Диагностика хориоидальных метастазов у больных без предшествующего онкологического анамнеза. Онкохирургия. 2013;5(Прил. 1): 115–6.
  13. Пармон ЯВ, Саакян СВ. Комплексная диагностика метастазов в хориоидею у больных без предшествующего онкологического анамнеза. Голова и шея. 2013;(2): 7–11.
  14. Demirci H, Shields CL, Chao AN, Shields JA. Uveal metastasis from breast cancer in 264 patients. Am J Ophthalmol. 2003;136(2): 264–71. doi: http://dx.doi.org/10.1016/S0002-9394(03)00192-2.
  15. Donaldson MJ, Pulido JS, Mullan BP, Inwards DJ, Cantrill H, Johnson MR, Han MK. Combined positron emission tomography/computed tomography for evaluation of presumed choroidal metastases. Clin Exp Ophthalmol. 2006;34(9): 846–51. doi: 10.1111/j.1442-9071.2006.01364.x.

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Copyright (c) 2017 Parmon Y.V., Saakyan S.V.

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