Neoplastic diseases of the eye and adnexa MM iris Tumor tissue change, which is a result of the locally noncontrolable growth of autonomous nature. The biological nature of the tumor: benign malignant Classification of eye tumors according to anatomic localization: eyelid tumors tumors of the eye orbital tumors Eyelids tumors Location: mainly a cosmetic problem malposition and dysfunction of the eyelids with symptoms of dry eye syndrome (burning, cutting, more frequent sec. infections, xerosis of the conjunctiva, exposure keratopathy a reduction or even loss of the eye ZO) Treatment: (Depending on size, location and nature of the changes) Early excision with a sufficiently large safety rim histological verification Benign eyelids tumors Location: anywhere on the lid, without age limitation mostly a cosmetic problem Papilloma - cutaneous horns Verruca, verruca senile Hemangioma Nevus Treatment: Observation (nevi) Surgery - cautery, simple excision Histological examination hemangioma | vascular tumor Benign eyelids tumors mazova-cysta papilom Retention cyst Eyelids papiloma Malignant eyelid tumors Location: predilectively lower lid, 6.-7. decade of life basal cell carcinoma (invasion only local) squamous cell carcinoma(metastasizes) malignant melanoma Meibom glands carcinoma Treatment: surgical excision - simple - with transplant (free or sliding) radiotherapy surgery followed by radiotherapy Oncologic dispensary! Malignant eyelid tumors PICT0271 PICT0033 PICT0277 Basal cell carcinoma Tumors of the conjunctiva and cornea Location: all ages, a shift to a higher age Treatment: dispensary congenital change without progression - photographs (cosmetic point of view) surgical - block excision, lamellar keratectomy, in malignancies completed with cryotherapy - radical excision (up orbit exenteration) additional local radiotherapy local application of antimetabolites Histological examination! Oncological dispensary in melanoma and cancer! Benign tumors of the conjunctiva and cornea Congenital: Choristoma - dermoid, lipodermoid Hemangioma Epithelial: Hyperplasia Epithelioma (carcinoma in situ, Bowen's disease) Melanotic: Melanosis - congenital - acquired (with or without atypia atypical) Nevus, Melanocytoma (kong. based) Benign tumors of the conjunctiva and cornea dermoliptom_spojivky lymfangiom_spojivky papilom_spojivky conjunctival papiloma conjunctival lipodermoid conjunctival lymfangioma Benign tumors of the conjunctiva and cornea CIN melanoza_spojivky pigmentovy_nevus_karunkuly conjunctival nevus carcinoma in situ conjunctival melanosis Malignant tumors of the conjuntiva and cornea • Malignant melanoma of the conjunctiva • Carcinoma of the conjunctiva ( rare disease)) • Lymfoma of the conjunctiva (Non – Hodgkin type) maligni_melanom_spojivky metastaza_non-Hodkginova_lymfomu conjunctival malignant melanoma conjunctival lymfoma Intraocular tumors Primary: the origin of the uvea (iris, ciliary body, choroid) originate in the retina Secondary: infiltrative growth of surrounding tissue Metastatic: following generalization of the malignancy most common in the choroid (often the first symptom of malignancy) Metastases - women breast carcinoma 85%, bronchi 8% - male lung carcinoma 38%, GIT 20% Malignant melanoma of the uvea( MMU ) n ØIris 8% ØCiliary body 12% ØChorioid 80% n Øthe most common primary intraocular tumor of adults Øincidence between 50-70 years Øfeatured mortality 30 -70% most often Ø Øunilateral MMUdoo1 Obsah obrázku bezobratlí Popis byl vytvořen automaticky Obsah obrázku oranžová Popis byl vytvořen automaticky Obsah obrázku interiér, zavřít Popis byl vytvořen automaticky MMU Diagnostics nExamination on the slit lamp nOphthalmoscopy Ø direct Ø indirect Ø biomicroskopye Ø gonioscopy n nSonography Ø B scan Ø standard. echography Ø UBM n MMUdoo1 experience With Ultrasonography in the diagnosis and treatment of Uveal melanoma MMU diagnostics nFAG ( fluorescein angiography ) nICG ( indocyanin angiography ) nNMR, PET n MMUdoo2 Examinations performed in determining the MMU diagnosis ØComplet laboratory examinations including oncomarkers ØLungs X ray scans ØEchography of parenchymatous organs of the abdomen ØBrain NMR Ø ØOncological examination Ø ( PET ) n Therapy of choroidal MM ØBrachytherapy ØEnucleation of the bulb ØExenteration of the orbit n Brachytherapy n Indication ØHeight to 10 mm ØBases to 15 mm n radioaktivni zaric radioactive source 106Ru Enucleation of the bulb Ø height above 8-10 mm Ø bases above 15 mm Ø small range extrabulbar extension Ø blind and painfull bulbs with secondary glaucoma ocni protezka extraokularni_propagace_difusniho_melanomu Socket Man Exenteration of the orbit n Indications: Øretrobulbar extension of the tumor Øsignificant peribulbar extension of the tumor n Obsah obrázku interiér, osoba, ústa, zubní kartáček Popis byl vytvořen automaticky Iris malignant melanoma Ømost common occurrence in the lower half of the iris Øvarious pigment Ødistortion of the pupil Øectopia of pigmented sheet Øpartial cataract MM iris Treatment of benign and malignant lesions of the iris Ø monitoring borderline findings (photographs) Ø excision - in suspected lesions notoverlaping 4 hours Ø enucleation of the globe - susp. malignant lesions over 1/2 of the iris, blind bulb, noncorrected secondary glaucoma S000011B S0000139 Ciliary body malignant melanoma Ølong asymptomatic Øextension episcleral vessels Øpressure on the lens (astigmatism, partial cataract, subluxation) Øsecondary retinal detachment Øiris root erosion Øsecondary glaucoma after initial hypotension Øepibulbar meat in place of extrabulbar extension Mm-cc4 MM-CC1 Therapy of ciliary body melanomas Øcyclectomy Øiridocyclectomy Øradiotherapy - brachytherapy n Øenucleation n n n n n n Obsah obrázku interiér, kobliha Popis byl vytvořen automaticky Choroidal metastasis metla MetaI1 MetaI2 Obsah obrázku světlo Popis byl vytvořen automaticky Choroidal hemangioma horava 01 HORAVA02 Horava ICG OS Retinoblastoma – most common intraocular tumor in childhood Retinob2 Retinob3 pravostranna_leukokorie Tumors of the orbit Symptoms: Ø changes in the position of the eye - the eye protrusion or deviations Ø double vision (binocular diplopia) Ø eyelid symptoms - edema of the eyelids, drooping of the eyelid Ø swelling and redness of the conjunctiva Ø pain - a frequent symptom! ( from oppression, sec. glaucoma) Ø decrease in visual acuity from the oppression of the optic nerve Ø visual field changes Tumors of the orbit - distribution Primary – primary formation in orbit tissues Ø Benign - inflammation pseudotumor, vascular – hemangioma, lacrimal gland adenoma Ø Malignant - primary lymfoma, rabdomyosarkoma, meningeoma of the optic nerve, lacrimal gland and sac adenocarcinoma Secondary – ingrowth from sinuses and CNS Ø Benign - dermoid cysta, mucocele and pyocele Ø Malignant – sinuses carcinoma , wedge bone meningeoma, conjunctival and uveal malignant melanoma, eyelids carcinoma Metastatic – blood or lymfatic vessels Ø always malignant – bronchogenic carcinoma, breast carcinoma, GIS carcinoma, haemoblastoma Primary tumors of the orbit lososd lymfoma of the orbit secondary tumors of the orbit Zalesky_Jan_2_2 DSCN1656 adenocarcinoma of the orbit bazalioma of the orbit Orbital cavernous venous malformation | Radiology Reference Article | Radiopaedia.org Obsah obrázku text, lupenonožci, černá, členovci Popis byl vytvořen automaticky Metastatic tumors of the orbit CT P1010138 Obsah obrázku osoba, interiér, zubní kartáček, zavřít Popis byl vytvořen automaticky Rhabdomyosarcoma Diagnostics of orbit tumors Ø Complet ophtalmological examinatin Ø Radiodiagnostic methods - RTG, CT, NMR, Digit. substr. angiografie (morphology of the lesion in PNS or CNS) Biopsy Ø Interdisciplinary cooperation Treatment of oncological diseases of the orbit Surgery ( interdisciplinary cooperation) Ø extirpation (boundad lesions) Ø extirpation with resection of surrounding structurs Ø exenteration of the orbit without or with resection of PND Ø Radiotherapy Ø primary ( lymfoma of the orbit, pseudotumors ) Combined Ø surgery with radiotherapy or chemotherapy Ø