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Adenocarcinoma of the retinal pigment epithelium: a diagnostic and therapeutic challenge.

Publication ,  Journal Article
Finger, PT; McCormick, SA; Davidian, M; Walsh, JB
Published in: Graefes Arch Clin Exp Ophthalmol
August 1996

BACKGROUND: Adenocarcinoma of the retinal pigment epithelium (RPE) is an uncommon intraocular tumor which has been rarely if ever diagnosed prior to enucleation. Our review of the literature suggests that when a melanotic and tuberous-shaped tumor presents in a woman with signs of uveitis one should consider the diagnosis of adenocarcinoma of the RPE. METHODS: We report a case in which a 4.9-mm-tall, mushroom-shaped, moderately reflective melanotic tumor found to be present in a 50-year-old woman. Other findings included a 12 x 10-mm dense transillumination shadow and 270 deg of posterior iris synechiae. With a presumptive diagnosis of uveal melanoma the patient was treated with palladium-103 plaque radiotherapy. Within 6 months she underwent enucleation due to uncontrollable ocular pain and progressive tumor growth. Histopathologic evaluation revealed an adenocarcinoma of the (RPE). RESULTS: Two months after radiotherapy the eye developed acute angle-closure glaucoma, secondary retinal detachment, and a painful scleritis (a result similar to that of Greer, who treated an intraocular adenoma with radiation). Our diagnosis of adenocarcinoma of the RPE was made after enucleation. CONCLUSION: Adenocarcinomas of the RPE are rarely if ever diagnosed on clinical evaluation, should be suspected in women with a melanotic intraocular tumor and uveitis, and may respond poorly to ophthalmic plaque radiotherapy. All reported cases presenting without extrascleral extension have not metastasized.

Duke Scholars

Published In

Graefes Arch Clin Exp Ophthalmol

DOI

ISSN

0721-832X

Publication Date

August 1996

Volume

234 Suppl 1

Start / End Page

S22 / S27

Location

Germany

Related Subject Headings

  • Ultrasonography
  • Retinal Diseases
  • Radioisotopes
  • Pigment Epithelium of Eye
  • Palladium
  • Ophthalmoscopy
  • Ophthalmology & Optometry
  • Middle Aged
  • Male
  • Humans
 

Citation

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MLA
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Finger, P. T., McCormick, S. A., Davidian, M., & Walsh, J. B. (1996). Adenocarcinoma of the retinal pigment epithelium: a diagnostic and therapeutic challenge. Graefes Arch Clin Exp Ophthalmol, 234 Suppl 1, S22–S27. https://doi.org/10.1007/BF02343044
Finger, P. T., S. A. McCormick, M. Davidian, and J. B. Walsh. “Adenocarcinoma of the retinal pigment epithelium: a diagnostic and therapeutic challenge.Graefes Arch Clin Exp Ophthalmol 234 Suppl 1 (August 1996): S22–27. https://doi.org/10.1007/BF02343044.
Finger PT, McCormick SA, Davidian M, Walsh JB. Adenocarcinoma of the retinal pigment epithelium: a diagnostic and therapeutic challenge. Graefes Arch Clin Exp Ophthalmol. 1996 Aug;234 Suppl 1:S22–7.
Finger, P. T., et al. “Adenocarcinoma of the retinal pigment epithelium: a diagnostic and therapeutic challenge.Graefes Arch Clin Exp Ophthalmol, vol. 234 Suppl 1, Aug. 1996, pp. S22–27. Pubmed, doi:10.1007/BF02343044.
Finger PT, McCormick SA, Davidian M, Walsh JB. Adenocarcinoma of the retinal pigment epithelium: a diagnostic and therapeutic challenge. Graefes Arch Clin Exp Ophthalmol. 1996 Aug;234 Suppl 1:S22–S27.
Journal cover image

Published In

Graefes Arch Clin Exp Ophthalmol

DOI

ISSN

0721-832X

Publication Date

August 1996

Volume

234 Suppl 1

Start / End Page

S22 / S27

Location

Germany

Related Subject Headings

  • Ultrasonography
  • Retinal Diseases
  • Radioisotopes
  • Pigment Epithelium of Eye
  • Palladium
  • Ophthalmoscopy
  • Ophthalmology & Optometry
  • Middle Aged
  • Male
  • Humans