Histopathologic characteristics of uveal melanomas in eyes enucleated from the collaborative ocular melanoma study COMS report no. 6

D. M. Albert; M. Diener-West; N. L. Robinson; H. E. Grossniklaus; W. R. Green; A. K. Vine; J. Willis; B. Frueh; R. M. Kurtz; S. Elner; M. W. Johnson; S. R. Sneed; J. Hayman; A. S. Lichter; C. J. McGinn; J. M. Robertson; S. Schoeppel; R. T. Haken; A. V. Thompson; K. A. Meyer; C. Martonyi; S. A. Stanley; V. Elner; M. Kincaid; R. J. Wolter; Jr Sternberg P.; J. M. Brown; Sr Aaberg; Jr Capone A.; T. H. Wojno; J. Lim; J. W. Keller; J. Landry; I. Crocker; J. McLaren; C. A. Aguilera; E. Butler; K. A. Klee; D. Strongosky; D. K. Gibbs; L. T. Curtis; A. Fremstad; R. G. Waldron; A. Ward; J. Gilman; R. A. Myles; R. Swords; F. P. Calhoun; W. Campbell; W. H. Jarrett; W. S. Hagler; R. L. Halpen; N. Jones; F. P. Schwaibold; K. J. Wynn; P. Mondalek; G. A. Degenhardt; E. K. Hulsey; D. H. Lee; J. Aaron; D. Bolerjak; S. McCart; G. McCoy; K. D. Thompson; B. Baxter; B. Robinson; K. Wilson; A. P. Schachat; Jr Doll; E. F. Greenberg; M. F. Alexander; C. S. Sackett; M. F. Goldberg; L. H. Hammer; N. T. Iliff; D. J. Lee; M. Chun; J. F. Jackson; J. Iannito; W. C. Lam; L. Pollack; C. DiBernardo; D. Cain; D. Emmert; T. George; Z. N. Zakov; T. A. Rice; M. Hartnett; S. E. Lichterman; K. Dempsey; D. Preseren; J. H. Niffenegger; M. A. Novak; S. D. Pendergast; L. J. Singermann; D. Weidenthal; H. Zegarra; J. Antoszyk

doi:10.1016/S0002-9394(98)00040-3

Histopathologic characteristics of uveal melanomas in eyes enucleated from the collaborative ocular melanoma study COMS report no. 6

D. M. Albert, M. Diener-West, N. L. Robinson, H. E. Grossniklaus, W. R. Green, A. K. Vine, J. Willis, B. Frueh, R. M. Kurtz, S. Elner, M. W. Johnson, S. R. Sneed, J. Hayman, A. S. Lichter, C. J. McGinn, J. M. Robertson, S. Schoeppel, R. T. Haken, A. V. Thompson, K. A. MeyerC. Martonyi, S. A. Stanley, V. Elner, M. Kincaid, R. J. Wolter, Jr Sternberg P., J. M. Brown, Sr Aaberg, Jr Capone A., T. H. Wojno, J. Lim, J. W. Keller, J. Landry, I. Crocker, J. McLaren, C. A. Aguilera, E. Butler, K. A. Klee, D. Strongosky, D. K. Gibbs, L. T. Curtis, A. Fremstad, R. G. Waldron, A. Ward, J. Gilman, R. A. Myles, R. Swords, F. P. Calhoun, W. Campbell, W. H. Jarrett, W. S. Hagler, R. L. Halpen, N. Jones, F. P. Schwaibold, K. J. Wynn, P. Mondalek, G. A. Degenhardt, E. K. Hulsey, D. H. Lee, J. Aaron, D. Bolerjak, S. McCart, G. McCoy, K. D. Thompson, B. Baxter, B. Robinson, K. Wilson, A. P. Schachat, Jr Doll, E. F. Greenberg, M. F. Alexander, C. S. Sackett, M. F. Goldberg, L. H. Hammer, N. T. Iliff, D. J. Lee, M. Chun, J. F. Jackson, J. Iannito, W. C. Lam, L. Pollack, C. DiBernardo, D. Cain, D. Emmert, T. George, Z. N. Zakov, T. A. Rice, M. Hartnett, S. E. Lichterman, K. Dempsey, D. Preseren, J. H. Niffenegger, M. A. Novak, S. D. Pendergast, L. J. Singermann, D. Weidenthal, H. Zegarra, J. Antoszyk

Research output: Contribution to journal › Article › peer-review

244 Scopus citations

Abstract

PURPOSE: To describe the principal histopathologic findings in a series of 1,527 globes with uveal melanoma and the relationship of these findings to each other. METHODS: All eyes enucleated in the Collaborative Ocular Melanoma Study (COMS) were examined independently by three ophthalmic pathologists and the findings recorded on a data form. A composite of findings was obtained after adjudication. RESULTS: The diagnosis was choroidal melanoma in 1,527 (99.7%) of 1,532 cases examined. Misdiagnoses were metastatic adenocarcinoma (four) and hemangioma (one). Spindle cell (9.0%), mixed cell (86.0%), and epithelioid cell (5.0%) types were observed. Medium tumors were located more posteriorly than large tumors. Considerable local invasion was seen: rupture of Bruch's membrane (87.7%), invasion of the retina (49.1%), tumor cells in the vitreous (25.2%), vortex vein invasion (8.9%), invasion of tumor vessels by tumor cells (13.8%), and invasion into emissary canals (55.0%). Overall, 81.1% demonstrated local invasion, excluding rupture of Bruch's membrane. Scleral invasion was present in 55.7% of eyes, and extrascleral extension was present in 8.2%. Mitotic activity was significantly reduced in eyes that had received pre-enucleation radiation treatment (P < .001). The number of macrophages in the tumor increased with increased pigmentation (P < .001) and increased necrosis (P < .01). CONCLUSION: The accuracy of diagnosis in the COMS is high, with histopathologic confirmation of the diagnosis at 99.7%. Extensive local invasion of the tumor was seen. Pre-enucleation irradiation significantly reduced the number of mitotic figures. An association was found regarding the presence of macrophages, the level of pigmentation, and degree of necrosis.

Original language	English (US)
Pages (from-to)	745-766
Number of pages	22
Journal	American journal of ophthalmology
Volume	125
Issue number	6
DOIs	https://doi.org/10.1016/S0002-9394(98)00040-3
State	Published - Jun 1 1998
Externally published	Yes

ASJC Scopus subject areas

Ophthalmology

Access to Document

10.1016/S0002-9394(98)00040-3

Cite this

Albert, D. M., Diener-West, M., Robinson, N. L., Grossniklaus, H. E., Green, W. R., Vine, A. K., Willis, J., Frueh, B., Kurtz, R. M., Elner, S., Johnson, M. W., Sneed, S. R., Hayman, J., Lichter, A. S., McGinn, C. J., Robertson, J. M., Schoeppel, S., Haken, R. T., Thompson, A. V., ... Antoszyk, J. (1998). Histopathologic characteristics of uveal melanomas in eyes enucleated from the collaborative ocular melanoma study COMS report no. 6. American journal of ophthalmology, 125(6), 745-766. https://doi.org/10.1016/S0002-9394(98)00040-3

Albert, DM, Diener-West, M, Robinson, NL, Grossniklaus, HE, Green, WR, Vine, AK, Willis, J, Frueh, B, Kurtz, RM, Elner, S, Johnson, MW, Sneed, SR, Hayman, J, Lichter, AS, McGinn, CJ, Robertson, JM, Schoeppel, S, Haken, RT, Thompson, AV, Meyer, KA, Martonyi, C, Stanley, SA, Elner, V, Kincaid, M, Wolter, RJ, Sternberg P., J, Brown, JM, Aaberg, S, Capone A., J, Wojno, TH, Lim, J, Keller, JW, Landry, J, Crocker, I, McLaren, J, Aguilera, CA, Butler, E, Klee, KA, Strongosky, D, Gibbs, DK, Curtis, LT, Fremstad, A, Waldron, RG, Ward, A, Gilman, J, Myles, RA, Swords, R, Calhoun, FP, Campbell, W, Jarrett, WH, Hagler, WS, Halpen, RL, Jones, N, Schwaibold, FP, Wynn, KJ, Mondalek, P, Degenhardt, GA, Hulsey, EK, Lee, DH, Aaron, J, Bolerjak, D, McCart, S, McCoy, G, Thompson, KD, Baxter, B, Robinson, B, Wilson, K, Schachat, AP, Doll, J, Greenberg, EF, Alexander, MF, Sackett, CS, Goldberg, MF, Hammer, LH, Iliff, NT, Lee, DJ, Chun, M, Jackson, JF, Iannito, J, Lam, WC, Pollack, L, DiBernardo, C, Cain, D, Emmert, D, George, T, Zakov, ZN, Rice, TA, Hartnett, M, Lichterman, SE, Dempsey, K, Preseren, D, Niffenegger, JH, Novak, MA, Pendergast, SD, Singermann, LJ, Weidenthal, D, Zegarra, H & Antoszyk, J 1998, 'Histopathologic characteristics of uveal melanomas in eyes enucleated from the collaborative ocular melanoma study COMS report no. 6', American journal of ophthalmology, vol. 125, no. 6, pp. 745-766. https://doi.org/10.1016/S0002-9394(98)00040-3

@article{a7289f216fb247a4923edef7850cb96e,

title = "Histopathologic characteristics of uveal melanomas in eyes enucleated from the collaborative ocular melanoma study COMS report no. 6",

abstract = "PURPOSE: To describe the principal histopathologic findings in a series of 1,527 globes with uveal melanoma and the relationship of these findings to each other. METHODS: All eyes enucleated in the Collaborative Ocular Melanoma Study (COMS) were examined independently by three ophthalmic pathologists and the findings recorded on a data form. A composite of findings was obtained after adjudication. RESULTS: The diagnosis was choroidal melanoma in 1,527 (99.7%) of 1,532 cases examined. Misdiagnoses were metastatic adenocarcinoma (four) and hemangioma (one). Spindle cell (9.0%), mixed cell (86.0%), and epithelioid cell (5.0%) types were observed. Medium tumors were located more posteriorly than large tumors. Considerable local invasion was seen: rupture of Bruch's membrane (87.7%), invasion of the retina (49.1%), tumor cells in the vitreous (25.2%), vortex vein invasion (8.9%), invasion of tumor vessels by tumor cells (13.8%), and invasion into emissary canals (55.0%). Overall, 81.1% demonstrated local invasion, excluding rupture of Bruch's membrane. Scleral invasion was present in 55.7% of eyes, and extrascleral extension was present in 8.2%. Mitotic activity was significantly reduced in eyes that had received pre-enucleation radiation treatment (P < .001). The number of macrophages in the tumor increased with increased pigmentation (P < .001) and increased necrosis (P < .01). CONCLUSION: The accuracy of diagnosis in the COMS is high, with histopathologic confirmation of the diagnosis at 99.7%. Extensive local invasion of the tumor was seen. Pre-enucleation irradiation significantly reduced the number of mitotic figures. An association was found regarding the presence of macrophages, the level of pigmentation, and degree of necrosis.",

author = "Albert, {D. M.} and M. Diener-West and Robinson, {N. L.} and Grossniklaus, {H. E.} and Green, {W. R.} and Vine, {A. K.} and J. Willis and B. Frueh and Kurtz, {R. M.} and S. Elner and Johnson, {M. W.} and Sneed, {S. R.} and J. Hayman and Lichter, {A. S.} and McGinn, {C. J.} and Robertson, {J. M.} and S. Schoeppel and Haken, {R. T.} and Thompson, {A. V.} and Meyer, {K. A.} and C. Martonyi and Stanley, {S. A.} and V. Elner and M. Kincaid and Wolter, {R. J.} and {Sternberg P.}, Jr and Brown, {J. M.} and Sr Aaberg and {Capone A.}, Jr and Wojno, {T. H.} and J. Lim and Keller, {J. W.} and J. Landry and I. Crocker and J. McLaren and Aguilera, {C. A.} and E. Butler and Klee, {K. A.} and D. Strongosky and Gibbs, {D. K.} and Curtis, {L. T.} and A. Fremstad and Waldron, {R. G.} and A. Ward and J. Gilman and Myles, {R. A.} and R. Swords and Calhoun, {F. P.} and W. Campbell and Jarrett, {W. H.} and Hagler, {W. S.} and Halpen, {R. L.} and N. Jones and Schwaibold, {F. P.} and Wynn, {K. J.} and P. Mondalek and Degenhardt, {G. A.} and Hulsey, {E. K.} and Lee, {D. H.} and J. Aaron and D. Bolerjak and S. McCart and G. McCoy and Thompson, {K. D.} and B. Baxter and B. Robinson and K. Wilson and Schachat, {A. P.} and Jr Doll and Greenberg, {E. F.} and Alexander, {M. F.} and Sackett, {C. S.} and Goldberg, {M. F.} and Hammer, {L. H.} and Iliff, {N. T.} and Lee, {D. J.} and M. Chun and Jackson, {J. F.} and J. Iannito and Lam, {W. C.} and L. Pollack and C. DiBernardo and D. Cain and D. Emmert and T. George and Zakov, {Z. N.} and Rice, {T. A.} and M. Hartnett and Lichterman, {S. E.} and K. Dempsey and D. Preseren and Niffenegger, {J. H.} and Novak, {M. A.} and Pendergast, {S. D.} and Singermann, {L. J.} and D. Weidenthal and H. Zegarra and J. Antoszyk",

note = "Funding Information: This work was supported under cooperative agreements EY06260, EY06284, and EY06887 with the National Eye Institute, which includes support from the National Cancer Institute, National Institutes of Health, Bethesda, Maryland; an unrestricted gift from Research to Prevent Blindness, Inc, New York, New York; and the Wisconsin Lions Eye Research Fund, Madison, Wisconsin. ",

year = "1998",

month = jun,

day = "1",

doi = "10.1016/S0002-9394(98)00040-3",

language = "English (US)",

volume = "125",

pages = "745--766",

journal = "American journal of ophthalmology",

issn = "0002-9394",

publisher = "Elsevier USA",

number = "6",

}

TY - JOUR

T1 - Histopathologic characteristics of uveal melanomas in eyes enucleated from the collaborative ocular melanoma study COMS report no. 6

AU - Albert, D. M.

AU - Diener-West, M.

AU - Robinson, N. L.

AU - Grossniklaus, H. E.

AU - Green, W. R.

AU - Vine, A. K.

AU - Willis, J.

AU - Frueh, B.

AU - Kurtz, R. M.

AU - Elner, S.

AU - Johnson, M. W.

AU - Sneed, S. R.

AU - Hayman, J.

AU - Lichter, A. S.

AU - McGinn, C. J.

AU - Robertson, J. M.

AU - Schoeppel, S.

AU - Haken, R. T.

AU - Thompson, A. V.

AU - Meyer, K. A.

AU - Martonyi, C.

AU - Stanley, S. A.

AU - Elner, V.

AU - Kincaid, M.

AU - Wolter, R. J.

AU - Sternberg P., Jr

AU - Brown, J. M.

AU - Aaberg, Sr

AU - Capone A., Jr

AU - Wojno, T. H.

AU - Lim, J.

AU - Keller, J. W.

AU - Landry, J.

AU - Crocker, I.

AU - McLaren, J.

AU - Aguilera, C. A.

AU - Butler, E.

AU - Klee, K. A.

AU - Strongosky, D.

AU - Gibbs, D. K.

AU - Curtis, L. T.

AU - Fremstad, A.

AU - Waldron, R. G.

AU - Ward, A.

AU - Gilman, J.

AU - Myles, R. A.

AU - Swords, R.

AU - Calhoun, F. P.

AU - Campbell, W.

AU - Jarrett, W. H.

AU - Hagler, W. S.

AU - Halpen, R. L.

AU - Jones, N.

AU - Schwaibold, F. P.

AU - Wynn, K. J.

AU - Mondalek, P.

AU - Degenhardt, G. A.

AU - Hulsey, E. K.

AU - Lee, D. H.

AU - Aaron, J.

AU - Bolerjak, D.

AU - McCart, S.

AU - McCoy, G.

AU - Thompson, K. D.

AU - Baxter, B.

AU - Robinson, B.

AU - Wilson, K.

AU - Schachat, A. P.

AU - Doll, Jr

AU - Greenberg, E. F.

AU - Alexander, M. F.

AU - Sackett, C. S.

AU - Goldberg, M. F.

AU - Hammer, L. H.

AU - Iliff, N. T.

AU - Lee, D. J.

AU - Chun, M.

AU - Jackson, J. F.

AU - Iannito, J.

AU - Lam, W. C.

AU - Pollack, L.

AU - DiBernardo, C.

AU - Cain, D.

AU - Emmert, D.

AU - George, T.

AU - Zakov, Z. N.

AU - Rice, T. A.

AU - Hartnett, M.

AU - Lichterman, S. E.

AU - Dempsey, K.

AU - Preseren, D.

AU - Niffenegger, J. H.

AU - Novak, M. A.

AU - Pendergast, S. D.

AU - Singermann, L. J.

AU - Weidenthal, D.

AU - Zegarra, H.

AU - Antoszyk, J.

N1 - Funding Information: This work was supported under cooperative agreements EY06260, EY06284, and EY06887 with the National Eye Institute, which includes support from the National Cancer Institute, National Institutes of Health, Bethesda, Maryland; an unrestricted gift from Research to Prevent Blindness, Inc, New York, New York; and the Wisconsin Lions Eye Research Fund, Madison, Wisconsin.

PY - 1998/6/1

Y1 - 1998/6/1

N2 - PURPOSE: To describe the principal histopathologic findings in a series of 1,527 globes with uveal melanoma and the relationship of these findings to each other. METHODS: All eyes enucleated in the Collaborative Ocular Melanoma Study (COMS) were examined independently by three ophthalmic pathologists and the findings recorded on a data form. A composite of findings was obtained after adjudication. RESULTS: The diagnosis was choroidal melanoma in 1,527 (99.7%) of 1,532 cases examined. Misdiagnoses were metastatic adenocarcinoma (four) and hemangioma (one). Spindle cell (9.0%), mixed cell (86.0%), and epithelioid cell (5.0%) types were observed. Medium tumors were located more posteriorly than large tumors. Considerable local invasion was seen: rupture of Bruch's membrane (87.7%), invasion of the retina (49.1%), tumor cells in the vitreous (25.2%), vortex vein invasion (8.9%), invasion of tumor vessels by tumor cells (13.8%), and invasion into emissary canals (55.0%). Overall, 81.1% demonstrated local invasion, excluding rupture of Bruch's membrane. Scleral invasion was present in 55.7% of eyes, and extrascleral extension was present in 8.2%. Mitotic activity was significantly reduced in eyes that had received pre-enucleation radiation treatment (P < .001). The number of macrophages in the tumor increased with increased pigmentation (P < .001) and increased necrosis (P < .01). CONCLUSION: The accuracy of diagnosis in the COMS is high, with histopathologic confirmation of the diagnosis at 99.7%. Extensive local invasion of the tumor was seen. Pre-enucleation irradiation significantly reduced the number of mitotic figures. An association was found regarding the presence of macrophages, the level of pigmentation, and degree of necrosis.

AB - PURPOSE: To describe the principal histopathologic findings in a series of 1,527 globes with uveal melanoma and the relationship of these findings to each other. METHODS: All eyes enucleated in the Collaborative Ocular Melanoma Study (COMS) were examined independently by three ophthalmic pathologists and the findings recorded on a data form. A composite of findings was obtained after adjudication. RESULTS: The diagnosis was choroidal melanoma in 1,527 (99.7%) of 1,532 cases examined. Misdiagnoses were metastatic adenocarcinoma (four) and hemangioma (one). Spindle cell (9.0%), mixed cell (86.0%), and epithelioid cell (5.0%) types were observed. Medium tumors were located more posteriorly than large tumors. Considerable local invasion was seen: rupture of Bruch's membrane (87.7%), invasion of the retina (49.1%), tumor cells in the vitreous (25.2%), vortex vein invasion (8.9%), invasion of tumor vessels by tumor cells (13.8%), and invasion into emissary canals (55.0%). Overall, 81.1% demonstrated local invasion, excluding rupture of Bruch's membrane. Scleral invasion was present in 55.7% of eyes, and extrascleral extension was present in 8.2%. Mitotic activity was significantly reduced in eyes that had received pre-enucleation radiation treatment (P < .001). The number of macrophages in the tumor increased with increased pigmentation (P < .001) and increased necrosis (P < .01). CONCLUSION: The accuracy of diagnosis in the COMS is high, with histopathologic confirmation of the diagnosis at 99.7%. Extensive local invasion of the tumor was seen. Pre-enucleation irradiation significantly reduced the number of mitotic figures. An association was found regarding the presence of macrophages, the level of pigmentation, and degree of necrosis.

UR - http://www.scopus.com/inward/record.url?scp=0037751710&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0037751710&partnerID=8YFLogxK

U2 - 10.1016/S0002-9394(98)00040-3

DO - 10.1016/S0002-9394(98)00040-3

M3 - Article

C2 - 9645714

AN - SCOPUS:0037751710

SN - 0002-9394

VL - 125

SP - 745

EP - 766

JO - American journal of ophthalmology

JF - American journal of ophthalmology

IS - 6

ER -

Histopathologic characteristics of uveal melanomas in eyes enucleated from the collaborative ocular melanoma study COMS report no. 6

Abstract

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this