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

Daniel 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, H. Grossniklaus, 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 journalArticle

175 Citations (Scopus)

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 languageEnglish (US)
Pages (from-to)745-766
Number of pages22
JournalAmerican journal of ophthalmology
Volume125
Issue number6
DOIs
StatePublished - Jun 1 1998
Externally publishedYes

Fingerprint

Melanoma
Neoplasms
Bruch Membrane
Pigmentation
Rupture
Necrosis
Macrophages
Epithelioid Cells
Hemangioma
Uveal melanoma
Diagnostic Errors
Retina
Veins
Adenocarcinoma
Radiation

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Histopathologic characteristics of uveal melanomas in eyes enucleated from the collaborative ocular melanoma study COMS report no. 6. / Albert, Daniel; 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.; Meyer, K. A.; Martonyi, C.; Stanley, S. A.; Elner, V.; Kincaid, M.; Wolter, R. J.; Sternberg P., Jr; Brown, J. M.; Aaberg, Sr; Capone A., Jr; Wojno, T. H.; Lim, J.; Keller, J. W.; Landry, J.; Crocker, I.; McLaren, J.; Aguilera, C. A.; Butler, E.; Klee, K. A.; Strongosky, D.; Gibbs, D. K.; Curtis, L. T.; Fremstad, A.; Waldron, R. G.; Ward, A.; Gilman, J.; Myles, R. A.; Swords, R.; Grossniklaus, H.; Calhoun, F. P.; Campbell, W.; Jarrett, W. H.; Hagler, W. S.; Halpen, R. L.; Jones, N.; Schwaibold, F. P.; Wynn, K. J.; Mondalek, P.; Degenhardt, G. A.; Hulsey, E. K.; Lee, D. H.; Aaron, J.; Bolerjak, D.; McCart, S.; McCoy, G.; Thompson, K. D.; Baxter, B.; Robinson, B.; Wilson, K.; Schachat, A. P.; Doll, Jr; Greenberg, E. F.; Alexander, M. F.; Sackett, C. S.; Goldberg, M. F.; Hammer, L. H.; Iliff, N. T.; Lee, D. J.; Chun, M.; Jackson, J. F.; Iannito, J.; Lam, W. C.; Pollack, L.; DiBernardo, C.; Cain, D.; Emmert, D.; George, T.; Zakov, Z. N.; Rice, T. A.; Hartnett, M.; Lichterman, S. E.; Dempsey, K.; Preseren, D.; Niffenegger, J. H.; Novak, M. A.; Pendergast, S. D.; Singermann, L. J.; Weidenthal, D.; Zegarra, H.; Antoszyk, J.

In: American journal of ophthalmology, Vol. 125, No. 6, 01.06.1998, p. 745-766.

Research output: Contribution to journalArticle

Albert, D, 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, Grossniklaus, H, 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
Albert, Daniel ; 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. ; Meyer, K. A. ; Martonyi, C. ; Stanley, S. A. ; Elner, V. ; Kincaid, M. ; Wolter, R. J. ; Sternberg P., Jr ; Brown, J. M. ; Aaberg, Sr ; Capone A., Jr ; Wojno, T. H. ; Lim, J. ; Keller, J. W. ; Landry, J. ; Crocker, I. ; McLaren, J. ; Aguilera, C. A. ; Butler, E. ; Klee, K. A. ; Strongosky, D. ; Gibbs, D. K. ; Curtis, L. T. ; Fremstad, A. ; Waldron, R. G. ; Ward, A. ; Gilman, J. ; Myles, R. A. ; Swords, R. ; Grossniklaus, H. ; Calhoun, F. P. ; Campbell, W. ; Jarrett, W. H. ; Hagler, W. S. ; Halpen, R. L. ; Jones, N. ; Schwaibold, F. P. ; Wynn, K. J. ; Mondalek, P. ; Degenhardt, G. A. ; Hulsey, E. K. ; Lee, D. H. ; Aaron, J. ; Bolerjak, D. ; McCart, S. ; McCoy, G. ; Thompson, K. D. ; Baxter, B. ; Robinson, B. ; Wilson, K. ; Schachat, A. P. ; Doll, Jr ; Greenberg, E. F. ; Alexander, M. F. ; Sackett, C. S. ; Goldberg, M. F. ; Hammer, L. H. ; Iliff, N. T. ; Lee, D. J. ; Chun, M. ; Jackson, J. F. ; Iannito, J. ; Lam, W. C. ; Pollack, L. ; DiBernardo, C. ; Cain, D. ; Emmert, D. ; George, T. ; Zakov, Z. N. ; Rice, T. A. ; Hartnett, M. ; Lichterman, S. E. ; Dempsey, K. ; Preseren, D. ; Niffenegger, J. H. ; Novak, M. A. ; Pendergast, S. D. ; Singermann, L. J. ; Weidenthal, D. ; Zegarra, H. ; Antoszyk, J. / Histopathologic characteristics of uveal melanomas in eyes enucleated from the collaborative ocular melanoma study COMS report no. 6. In: American journal of ophthalmology. 1998 ; Vol. 125, No. 6. pp. 745-766.
@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 = "Daniel Albert 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 H. Grossniklaus 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",
year = "1998",
month = "6",
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, Daniel

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 - Grossniklaus, H.

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.

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

VL - 125

SP - 745

EP - 766

JO - American Journal of Ophthalmology

JF - American Journal of Ophthalmology

SN - 0002-9394

IS - 6

ER -