27. Intraocular Tumours

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sookylala
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246654
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27. Intraocular Tumours
Updated:
2013-11-13 06:23:54
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Intraocular Tumours
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Intraocular Tumours
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  1. Iris melanoma?
    • small, rare, 40, slow growth, excellent prog
    • 2ndy glauc
  2. Ciliarybody melanoma?
    • vessels: ddx epi/scleritis
    • sentinel vessels, extraoc expansion, erosion of iris root, lens subluxation, cataract, RD
  3. Choroidal naevus?
    • grey, indistinct margins, flatish, asx
    • sus: elevation, lipofuscin
  4. Choroidal melanoma genetics?
    • most common primary intraoc tumour in adults
    • large tumour size, old
    • GNAQ mutation: early pathogenesis (-)metastasis
    • inactivation BAP1 (tumour/metasis suppressor)- monosomy 3: metastatic spread
    • gain 6p: better prognosis
    • gain 8p: worse prognosis
  5. choroidal melanoma signs?
    • brown, elevated subretinal mass
    • vessels on surface
    • SRD
    • choroidal folds- compression
  6. Choroidal melanoma metastasis?
    • bad prognosis
    • 50% metastases within 15 years tx primary
  7. DDX choroidal melanoma?
    • choroidal naevus
    • metastatic tumour
    • choroidal haemangioma
    • choroidal detachment/granuloma
    • subret haem
  8. Risk factors choroidal melanoma?
    • thickness
    • orange pigment
    • fluid
  9. Optic nerve melanocytoma?
    • asx, no growth~RAPD
    • slow growth compress ON-VA loss, CRVO
  10. ON melanocytoma vs melanoma?
    • melanoma: varied presenation, patchy pig, distorted bv
    • surface deposits
    • ret/disc edema, haem, RD
  11. Choroidal haemangioma?
    • adult
    • dome, placoid red-orange mass, post pole
    • blanch with pressure
    • SRD
    • cystoid retinal degen
    • REFER!
  12. choroidal osseous choristoma
    • rare, benign, slow bony tumour
    • 20-30 f
    • mottled appeareance, RPE defen over lesion
    • yellow, scalloped
  13. Retinoblastoma?
    • 13q14
    • mortatily!!
    • 2ndy cancers later life
    • bi
  14. Presentation of Rb?
    • leukocoria
    • strabismus
    • ant invasion, 
    • orbital inflammation
    • 2ndy glaucoma
  15. DDx leukocoria?
    • coloboma, cataract, coats
    • PHPV
    • RD
    • morning glory anomaly
    • toxocar
    • Rb
  16. Endo/exophytic Rb?
    • endo: grown into vit, friable white mass, cottage cheese, 
    • exo: proliferations in SRS- serous detachment
  17. Rb tx?
    • small: laser photo, cryo
    • medium: chemo
    • Large: chemo, enucleation
  18. Eye lymphoma?
    • b-cells
    • 50yo
    • PVRL: CNS lymphoma refer
  19. Metastatic carcinoma?
    • micrscopic metatstatic intraocular lesions
    • breast+lung
    • fast growing, creamy placoid lesion, post pole
    • multiple deposits
  20. Paraneoplastic syndrome?
    • rare
    • precede cancer- lung, melanoma, ovarian, prostate
    • immune response to cancer
    • CAR. MAR
  21. CAR/MAR sx?
    • acute vision loss, nyctalopia, photophobia, CV, flickering
    • PRECEDE CANCER-CAR
    • MAR- POST diagnosis
  22. MAR difference?
    ERG: b wave abnormal- ON bipolar cells

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