João Pessoa Souza Filho

Background: Few cases of malignant tumors arising in a blind painful eye have previously been described. We described two cases of a blind painful eye containing an unsuspected tumor, which were enucleated to relieve the pain. Case presentations: Case 1: A 57 year-old Caucasian man presented with recurrent orbital cellulitis and endophthalmitis in the left eye (OS). The OS was blind and painful and an enucleation was performed showing a uveal melanoma by histopathological exam. Case 2: A 54 year-old Caucasian man with previous history of a rhegmatogenous retinal detachment in his left eye presented a blind painful eye. Enucleation was performed revealing a well-differentiated B-cell lymphoma of uveal tract with extra ocular extension. Conclusion: In the management of a blind painful eye, it is extremely important to rule out an intraocular malignancy particularly in those patients who have not been followed by an ophthalmologist.

Purpose. To investigate the expression of P-glycoprotein (P-gp) in retinoblastoma specimens enucleated as a primary treatment or after conservative treatment and to correlate this expression with histopathological tumor features. methods. Retrospective analysis was performed on retinoblastoma specimens obtained consecutively between 1993 and 2003 by enucleation either as primary treatment (group I) or after the failure of conservative treatment (group II). Sections from the formalin-fixed, paraffin-embedded specimens were stained with hematoxylin and eosin. Group I tumor differentiation was classified according to the percentage of Flexner-Wintersteiner rosettes. Group II tumors, categorized as viable-appearing, regressed with a well-differentiated component (WDC), and regressed. Other features, such as choroidal and optic nerve invasion, were evaluated. P-gp expression was graded semiquantitatively as negative, low, or high. Variables were statistically analyzed by χ² and Student’s t-tests. results. Histopathological assessment of group I revealed 65% moderately differentiated tumors, 30% well differentiated, and 5% poorly differentiated. Fifteen percent had optic nerve tumor invasion only, 20% choroidal invasion only, and 55% both choroidal and optic nerve invasion. Group II had 62.5% well-differentiated, regressed tumors; 25% had regressed tumors replaced by glial scarring; and 12.5% had tumors containing viable, poorly differentiated cells. Approximately 18% had choroidal tumor invasion only, 6.3% optic nerve tumor invasion only, and 6.3% simultaneous optic nerve and choroidal invasion. P-gp expression was observed in 60% of group I and 66.6% of group II. All P-gp-positive cases in group II had a high expression. P-gp was also expressed by 81.2% of well-differentiated tumors. conclusions. P-gp was expressed more frequently by well-differentiated retinoblastomas, especially those treated by chemotherapy before enucleation. This finding could be related to treatment failure.

Purpose Methods Result Conclusion

Background: P-glycoprotein (P-gp) has been identified as a possible mediator of chemoresistance in retinoblastoma. the aim of this study was to determine the expression of P-gp in retinoblastoma treated with chemotherapy prior to enucleation.Methods: Seventeen enucleated specimens of retinoblastoma from 16 patients were studied. Nine had been treated with chemotherapy alone, and eight had been treated with chemotherapy and other forms of local treatment. Tumour differentiation as well as choroidal and optic nerve invasion were assessed. P-gp immunohistochemical staining was performed and evaluated as negative, low or high.Results: Histopathological assessment of the cases showed that 14 of 17 eyes (82.3%) had viable retinoblastoma cells. Nine retinoblastomas were considered regressed with a well-differentiated component, five regressed retinoblastomas had viable cells with poor differentiation and three retinoblastomas had regressed leaving no viable cells. Sixteen of 17 retinoblastomas were P-gp positive. in the one case with optic nerve invasion and the three cases with massive choroidal invasion, P-gp expression was found in invading retinoblastoma cells.Conclusion: Almost all retinoblastomas expressed P-gp. High levels of P-gp expression might play a role in chemotherapy resistance of retinoblastoma or, conversely, chemotherapy might induce P-gp expression. These results might have an impact on management of bilateral retinoblastoma.Universidade Federal de São Paulo, Dept Ophthalmol, São Paulo, BrazilMcGill Univ, Henry C Witelson Ocular Pathol Lab, Dept Ophthalmol, Montreal, PQ, CanadaUniversidade Federal de São Paulo, Dept Ophthalmol, São Paulo, BrazilWeb of Scienc

A 53-year-old male presented with a progressive mass of the left orbit. His medical history included an invasive carcinoma of the bladder diagnosed three weeks earlier. An orbital biopsy was performed and the diagnosis was that of an orbital metastasis of urinary bladder carcinoma. The patient developed widespread metastatic disease and unfortunately died one month after the diagnosis of orbital metastasis. Orbital metastasis of urinary bladder carcinoma is associated with a poor prognosis and is more frequently observed in older people. In addition, it is five times more prevalent in men than in women.

Background: Oncocytoma is an uncommon, relatively benign tumor, composed of transformed epithelial cells of the ducts. We report a case of oncocytoma of the caruncle. Methods Case report. Results: A 51-year-old woman with a 2 years history of a mass located in the caruncle of her right eye was presented. Surgical excision was then performed, and the histological diagnosis of oncocytoma was established. Conclusion: The oncocytoma should be considered in the differential diagnosis of a caruncular mass in elderly people, particularly in female patients.