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Ocular oncology
 
 
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Ocular oncology is the branch of medicine
Medicine

Medicine is the art and science of healing. It encompasses a range of health care practices evolved to maintain and restore health by the prevention and treatment of illness....
 dealing with tumors relating to the eye
Eye

Eyes are Organ that detect light, and send signals along the optic nerve to the visual system and other areas of the brain. Complex optical systems with resolving power have come in ten fundamentally different forms, and 96% of animal species possess a complex optical system....
 and its adnexa
Adnexa

In anatomy, adnexa refers to the Appendage of an organ. ...
. Eye cancer can affect all parts of the eye
Eye

Eyes are Organ that detect light, and send signals along the optic nerve to the visual system and other areas of the brain. Complex optical systems with resolving power have come in ten fundamentally different forms, and 96% of animal species possess a complex optical system....
.

cancers can be primary (starts within the eye) and metastatic cancer
Metastasis

Metastasis , or Metastatic disease, sometimes abbreviated mets, is the spread of a disease from one Organ or part to another non-adjacent organ or part....
 (spread to the eye from another organ). The two most common cancers that spread to the eye from another organ are breast cancer
Breast cancer

Breast cancer is a cancer that starts in the Cell of the breast in women and men. Worldwide, breast cancer is the second most common type of cancer after lung cancer and the fifth most common cause of cancer death....
 and lung cancer
Lung cancer

Lung cancer is a disease of uncontrolled cell growth in tissue of the lung. This growth may lead to metastasis, which is the invasion of adjacent tissue and infiltration beyond the lungs....
. Other less common sites of origin include the prostate
Prostate

The prostate is a compound tubuloalveolar exocrine gland of the male mammalian reproductive system. Females do not have a prostate gland, although females do have tiny paraurethral Skene's glands connected to the distal third of the urethra in the prevaginal space that are homologous to the prostate....
, kidney
Kidney

The kidneys are Organ that have numerous biological roles. Their primary role is to maintain the homeostasis balance of bodily fluids by filtering and secreting Metabolomics#Metabolitess and minerals from the blood and excreting them, along with water , as urine....
, thyroid
Thyroid

The thyroid is one of the largest endocrine glands in the body. This gland is found in the neck inferior to the thyroid cartilage and at approximately the same level as the cricoid cartilage....
, skin
Skin

The skin is the outer covering of the body, also known as the epidermis. It is the largest organ of the integumentary system made up of multiple layers of epithelial biological tissue, and guards the underlying muscles, bones, ligaments and organ s....
, colon lymphoma and leukemia
Leukemia

Leukemia is a cancer of the blood or bone marrow and is characterized by an abnormal proliferation of blood Cell , usually white blood cells ....
.

rs in the eye and orbit can be benign
Benign

A benign tumor is a tumor that lacks all three of the malignant properties of a cancer. Thus, by definition, a benign tumor does not grow in an unlimited, aggressive manner, does not invade surrounding tissue , and does not metastasize....
 like dermoid cyst
Dermoid cyst

A dermoid cyst is a cystic teratoma that contains developmentally mature skin complete with hair follicles and sweat glands, sometimes luxuriant clumps of long hair, and often pockets of sebum, blood, fat, bone, Nail , teeth, eyes, cartilage, and thyroid tissue....
s, or malignant
Malignant

Malignant is a medical term used to describe a severe and progressively worsening disease. The term is most familiar as a description of cancer....
 like rhabdomyosarcoma
Rhabdomyosarcoma

A rhabdomyosarcoma is a type of cancer, specifically a sarcoma , in which the cancer cells are thought to arise from skeletal muscle progenitors....
 and retinoblastoma
Retinoblastoma

Retinoblastoma is a rapidly developing cancer which develops in the cells of the retina, the light sensitive cells of the eye. In the developed world, Rb has one of the best cure rates of all childhood cancers , with more than nine out of every ten sufferers surviving into adulthood....
.






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Encyclopedia


Ocular oncology is the branch of medicine
Medicine

Medicine is the art and science of healing. It encompasses a range of health care practices evolved to maintain and restore health by the prevention and treatment of illness....
 dealing with tumors relating to the eye
Eye

Eyes are Organ that detect light, and send signals along the optic nerve to the visual system and other areas of the brain. Complex optical systems with resolving power have come in ten fundamentally different forms, and 96% of animal species possess a complex optical system....
 and its adnexa
Adnexa

In anatomy, adnexa refers to the Appendage of an organ. ...
. Eye cancer can affect all parts of the eye
Eye

Eyes are Organ that detect light, and send signals along the optic nerve to the visual system and other areas of the brain. Complex optical systems with resolving power have come in ten fundamentally different forms, and 96% of animal species possess a complex optical system....
.

Eye cancer


Origin and location

Eye cancers can be primary (starts within the eye) and metastatic cancer
Metastasis

Metastasis , or Metastatic disease, sometimes abbreviated mets, is the spread of a disease from one Organ or part to another non-adjacent organ or part....
 (spread to the eye from another organ). The two most common cancers that spread to the eye from another organ are breast cancer
Breast cancer

Breast cancer is a cancer that starts in the Cell of the breast in women and men. Worldwide, breast cancer is the second most common type of cancer after lung cancer and the fifth most common cause of cancer death....
 and lung cancer
Lung cancer

Lung cancer is a disease of uncontrolled cell growth in tissue of the lung. This growth may lead to metastasis, which is the invasion of adjacent tissue and infiltration beyond the lungs....
. Other less common sites of origin include the prostate
Prostate

The prostate is a compound tubuloalveolar exocrine gland of the male mammalian reproductive system. Females do not have a prostate gland, although females do have tiny paraurethral Skene's glands connected to the distal third of the urethra in the prevaginal space that are homologous to the prostate....
, kidney
Kidney

The kidneys are Organ that have numerous biological roles. Their primary role is to maintain the homeostasis balance of bodily fluids by filtering and secreting Metabolomics#Metabolitess and minerals from the blood and excreting them, along with water , as urine....
, thyroid
Thyroid

The thyroid is one of the largest endocrine glands in the body. This gland is found in the neck inferior to the thyroid cartilage and at approximately the same level as the cricoid cartilage....
, skin
Skin

The skin is the outer covering of the body, also known as the epidermis. It is the largest organ of the integumentary system made up of multiple layers of epithelial biological tissue, and guards the underlying muscles, bones, ligaments and organ s....
, colon lymphoma and leukemia
Leukemia

Leukemia is a cancer of the blood or bone marrow and is characterized by an abnormal proliferation of blood Cell , usually white blood cells ....
.

Types

Tumors in the eye and orbit can be benign
Benign

A benign tumor is a tumor that lacks all three of the malignant properties of a cancer. Thus, by definition, a benign tumor does not grow in an unlimited, aggressive manner, does not invade surrounding tissue , and does not metastasize....
 like dermoid cyst
Dermoid cyst

A dermoid cyst is a cystic teratoma that contains developmentally mature skin complete with hair follicles and sweat glands, sometimes luxuriant clumps of long hair, and often pockets of sebum, blood, fat, bone, Nail , teeth, eyes, cartilage, and thyroid tissue....
s, or malignant
Malignant

Malignant is a medical term used to describe a severe and progressively worsening disease. The term is most familiar as a description of cancer....
 like rhabdomyosarcoma
Rhabdomyosarcoma

A rhabdomyosarcoma is a type of cancer, specifically a sarcoma , in which the cancer cells are thought to arise from skeletal muscle progenitors....
 and retinoblastoma
Retinoblastoma

Retinoblastoma is a rapidly developing cancer which develops in the cells of the retina, the light sensitive cells of the eye. In the developed world, Rb has one of the best cure rates of all childhood cancers , with more than nine out of every ten sufferers surviving into adulthood....
. The most common eyelid tumor is called basal cell carcinoma
Basal cell carcinoma

Basal cell carcinoma is the most common of all types of skin cancer. Statistically speaking, approximately 3 out of 10 caucasians develop a basal cell cancer within their lifetime....
. This tumor can grow around the eye but rarely spreads to other parts of the body. Other types of common eyelid cancers include squamous carcinoma, sebaceous carcinoma
Sebaceous carcinoma

Sebaceous carcinoma is an aggressive, uncommon, cutaneous tumor, it is usually of 10 mm size. This tumor is thought to arise from sebaceous glands in the skin, thus, it may arise anywhere in the body where these glands exist, knowing that the periocular region is rich in this type of gland, so this tumor commonly arise in this region....
 and malignant melanoma.

The most common malignant primary intraocular tumor in adults is uveal melanoma
Uveal melanoma

Uveal melanoma is a cancer of the eye involving the iris , ciliary body, or choroid . Tumors arise from the pigment cells that reside within the uvea giving color to the eye....
. These tumors can occur in the choroid
Choroid

The choroid, also known as the choroidea or choroid coat, is the Blood vessel layer of the eye lying between the retina and the sclera....
, iris
Iris (anatomy)

The iris is a membrane in the eye, responsible for controlling the amount of light reaching the retina. The iris consists of pigmented fibrovascular tissue known as a stroma of iris....
 and ciliary body
Ciliary body

The ciliary body is the circumferential tissue inside the eye composed of the ciliary muscle and ciliary processes. It is triangular in horizontal section, and is coated by a double layer, the ciliary epithelium....
. The latter are sometimes called iris or ciliary body melanoma
Ciliary body melanoma

Ciliary Body Melanoma is a type of cancer arising from the coloured part of the eye.About 12% of uveal melanoma arise from the ciliary body....
.

The most common malignant intraocular tumor in children is called retinoblastoma
Retinoblastoma

Retinoblastoma is a rapidly developing cancer which develops in the cells of the retina, the light sensitive cells of the eye. In the developed world, Rb has one of the best cure rates of all childhood cancers , with more than nine out of every ten sufferers surviving into adulthood....
. Affecting approximately 325 children per year in North America, early detection has allowed for cures exceeding 95%.

The next type of eye cancer which again occurs in children after retinoblastoma is called a medulloepithelioma (also called diktyoma) which can occur in the ciliary body and the uvea of the eye.

The most common orbital malignancy is orbital lymphoma. This tumor can be diagnosed by biopsy with histopathologic and immunohistochemical analysis. Most patients with orbital lymphoma can be offered chemotherapy
Chemotherapy

Chemotherapy, in its most general sense, refers to treatment of disease by chemicals that kill cells, specifically those of micro-organisms or cancer....
 or radiation therapy
Radiation therapy

Radiation therapy is the medicine use of ionizing radiation as part of cancer oncology to control malignant cell s . Radiotherapy may be used for curative or Adjuvant chemotherapy cancer treatment....
.

Orbital
Orbital

The term orbital has several meanings:In chemistry and physics:* Atomic orbital* Molecular orbitalIn astronomy and space flight:...
 dermoid cyst
Dermoid cyst

A dermoid cyst is a cystic teratoma that contains developmentally mature skin complete with hair follicles and sweat glands, sometimes luxuriant clumps of long hair, and often pockets of sebum, blood, fat, bone, Nail , teeth, eyes, cartilage, and thyroid tissue....
s are benign choristomas which are typically found at the junction of sutures, most commonly at the fronto-zygomatic suture. Large deep orbital dermoid cysts can have cause pressure effects on the muscles and optic nerve, leading to diplopia and loss of vision.

Eye cancer symptoms


  • Melanomas (choroidal, ciliary body and uveal) - In the early stages there may be no symptoms (the person does not know there is a tumor until an ophthalmologist or optometrist looks into the eye with an ophthalmoscope during a routine test). As the tumor grows, symptoms can be blurred vision, decreased vision, double vision, eventual vision loss and if they continue to grow the tumor can break past the retina causing retinal detachment. Sometimes the tumor can be visible through the pupil.


  • Nevus - Are benign, freckle in the eye. These should be checked out and regular checks on the eye done to ensure it hasn't turned into a melanoma.


  • Iris and conjuctival tumors (melanomas) - Presents as a dark spot. Any spot which continues to grow on the iris and the conjunctiva should be checked out.


  • Retinoblastoma - Strabismus (crossed eyes), a whitish or yellowish glow through the pupil, decreasing/loss of vision, sometimes the eye may be red and painful. Retinoblastoma can occur in one or both eyes. This tumor occurs in babies and young children. It is called RB for short. Please check photographs of your child or children, normal healthy eyes would have the red eye reflex, but a white/yellow dot instead of the red eye reflex can indicate a tumor or some other kind of eye disease. Any photos of a child/children which have a white/yellow dot instead of the red eye reflex should be checked out. Photographs of a child/children are very good clues as they can save the eyes, vision and lives of children, the other object is the ophthalmoscope.


Treatment


  • Laser therapy
  • Plaque therapy
  • Radiotherapy
  • Enucleation of the Eye - Removal of the eye, but the muscles, eyelids and muscles are left intact. An implant is inserted, then the person wears a conformer shield and later the person will have their prosthesis made and fitted (the prosthesis is made by someone called an ocularist and is made to look like their real eye)
  • Evisceration - Removal of the eye contents, leaving the sclera or the white part of the eye.
  • Exenteration - Removal of the eye, all orbital contents, which can involve the eyelids as well. A special prosthesis is made to cover the defect and improve appearance.


  • Iridectomy
    Iridectomy

    An iridectomy, also known as a surgical iridectomy or corectomy, is the surgery removal of part of the Iris . These procedures are most frequently performed in the treatment of closed-angle glaucoma and iris melanoma....
     - Removal of the affected piece of the iris
  • Choroidectomy - Removal of the choroid layer (the sandwich between the sclera and the retina)
  • Iridocyclectomy - Removal of the iris plus the ciliary body muscle.
  • Eyewall resection - Cutting into the eye to remove a tumor e.g. melanoma. This operation can be quite difficult to perform.
  • Chemotherapy
    Chemotherapy

    Chemotherapy, in its most general sense, refers to treatment of disease by chemicals that kill cells, specifically those of micro-organisms or cancer....


Classification


Choroidal tumors

  • Choroidal hemangioma
  • Choroidal melanoma
  • Choroidal metastasis
  • Choroidal nevus
  • Choroidal osteoma
  • Ciliary body melanoma
  • The nevus of Ota


Conjunctival tumors

  • Conjunctival Kaposi's sarcoma
  • Epibulbar dermoid
  • Malignant conjunctival tumors
  • Lymphoma of the conjunctiva
  • Melanoma and PAM with atypia
  • Pigmented conjunctival tumors
  • Pingueculum
  • Pterygium
  • Squamous carcinoma and intraepithelial neoplasia of the conjunctiva


Ocular oncology

Ocular oncology
Oncology

Oncology is the branch of medicine that studies tumors . A medical professional who practices oncology is an oncologist. The term originates from the Greek onkos , meaning bulk, mass, or tumor and the suffix -logy, meaning "study of"....
 takes into consideration that the primary requirement for patients is preservation of life by removal of the tumor, along with best efforts directed at preservation of useful vision, followed by cosmetic appearance. The treatment of ocular tumors is generally a multi-specialty effort, requiring coordination between the ophthalmologist, medical oncologist, radiation specialist, head & neck surgeon / ENT surgeon, pediatrician/internal medicine/hospitalist and a multidisciplinary team of support staff and nurses.

See also

  • List of eye diseases and disorders
    List of eye diseases and disorders

    This is a partial list of human eye diseases and disorders.The World Health Organization publishes a classification of known diseases and injuries called the ICD or ICD....


External links


Specific types

  • DeAngelis, D; Hurwitz, J. eMedicine.com. June 8, 2005.