International Journal of Ophthalmic PathologyISSN: 2324-8599

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Research Article, Int J Ophthalmic Pathol Vol: 2 Issue: 1

Primary Choroidal Melanoma with Divergent Neuroendocrine Differentiation

David E. Pelayes1,2, Juan P. Velazquez-Martin3*, Rand E. Simpson3 and Jorge O. Zarate2
1Department Ophthalmology, School of Medicine, Buenos Aires University, Argentina
2LIOCiV Laboratory of Ophthalmic Research and Visual Sciences, Department of Pathology, School of Medicine, Buenos Aires University, Buenos Aires, Argentina
3Ocular Oncology Clinic, Princess Margaret Hospital/University Health Network, Toronto, Canada
Corresponding author : Juan P. Velazquez-Martin, MD
Ocular Oncology Clinic, Princess Margaret Hospital, 18-704, 610 University Avenue, Toronto, Ontario, Canada M5G 2M9
Tel: (416) 946-2000/4501 x5430; Fax: (416) 946-2189
E-mail: [email protected]
Received: November 06, 2012 Accepted: February 06, 2013 Published: February 14, 2013
Citation: Pelayes DE, Velazquez-Martin JP, Simpson RE, Zarate JO (2013) Primary Choroidal Melanoma with Divergent Neuroendocrine Differentiation. Int J Ophthalmic Pathol 2:1. doi:10.4172/2324-8599.1000109

Abstract

Primary Choroidal Melanoma with Divergent Neuroendocrine Differentiation

Background: Despite well-defined histopathological characteristics, melanoma has been reported to have different histological and immunohistochemical variations that can lead to diagnostic controversy. Neuroendocrine divergent differentiation has been demonstrated previously in skin and metastatic melanoma, and also in metastatic tumors to the choroid, but not in primary choroidal melanoma.
Aim: To report the clinical, histopathological, immunohistochemical and ultrastructural characteristics of four cases of primary choroidal melanoma with neuroendocrine differentiation.
Methods and Results: A retrospective case series analysis was conducted for all patients with choroidal melanoma with confirmed histopathological features of neuroendocrine differentiation, evaluated at the Laboratory of Ophthalmic Research and Visual Sciences. Four cases were identified, two male and two female. Preoperative clinical diagnosis was choroidal melanoma for all cases. Atypical small-cell morphology distributed in a pattern forming an organoid, perivascular or nested architecture on light microscopy was found in all cases, which prompted further evaluation with neuroendocrine markers. Immunohistochemistry demonstrated positivity in at least three melanocytic and three neuroendocrine markers for each case. Hi-resolution optic microscopy showed granules corresponding to intracytoplasmic neurosecretory and melanin granules in the same cells, confirming the diagnosis.
Conclusions: In this study we provide evidence suggestive of divergent neuroendocrine differentiation in primary choroidal melanoma.

Keywords: Choroidal melanoma; Immunohistochemistry; Neuroendocrine differentiation

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