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Milman T, Grossniklaus HE, Goldman-Levy G, Kivelä TT, Coupland SE, White VA, Mudhar HS, Eberhart CG, Verdijk RM, Heegaard S, Gill AJ, Jager MJ, Rodríguez-Reyes AA, Esmaeli B, Hodge JC, Cree IA. The 5th Edition of the World Health Organization Classification of Tumours of the Eye and Orbit. Ocul Oncol Pathol 2023; 9:71-95. [PMID: 37900189 PMCID: PMC10601864 DOI: 10.1159/000530730] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 03/22/2023] [Indexed: 10/31/2023] Open
Affiliation(s)
- Tatyana Milman
- Departments of Ophthalmology and Pathology, Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - Hans E. Grossniklaus
- Departments of Ophthalmology and Pathology, Emory University School of Medicine, Atlanta, GA, USA
| | - Gabrielle Goldman-Levy
- World Health Organization, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Tero T. Kivelä
- Ophthalmic Pathology Laboratory, Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Sarah E. Coupland
- George Holt Chair of Pathology/Consultant Histopathologist, Liverpool Clinical Laboratories, Liverpool University Hospitals Foundation Trust, Liverpool, UK
| | - Valerie A. White
- World Health Organization, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Hardeep Singh Mudhar
- National Specialist Ophthalmic Pathology Service (NSOPS), Department of Histopathology, Royal Hallamshire Hospital, Sheffield, UK
| | - Charles G. Eberhart
- Departments of Pathology and Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Robert M. Verdijk
- Section Ophthalmic Pathology, Department of Pathology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Steffen Heegaard
- Department of Pathology, Eye Pathology Section and Ophthalmology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Anthony J. Gill
- Department of Pathology, University of Sydney, Sydney, NSW, Australia
- Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research, Royal North Shore Hospital St Leonards NSW, St Leonards, NSW, Australia
- NSW Health Pathology, Department of Anatomical Pathology, Royal North Shore Hospital, St Leonards NSW, St Leonards, NSW, Australia
| | - Martine J. Jager
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Abelardo A. Rodríguez-Reyes
- Ophthalmic Pathology Service, Asociación para Evitar la Ceguera en México, I.A.P. Faculty of Medicine, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | - Bita Esmaeli
- Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, MDAnderson Cancer Center, Houston, TX, USA
| | | | - Ian A. Cree
- World Health Organization, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - on behalf of the WHO Classification of Tumours Editorial Board
- Departments of Ophthalmology and Pathology, Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
- Departments of Ophthalmology and Pathology, Emory University School of Medicine, Atlanta, GA, USA
- World Health Organization, International Agency for Research on Cancer, World Health Organization, Lyon, France
- Ophthalmic Pathology Laboratory, Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- George Holt Chair of Pathology/Consultant Histopathologist, Liverpool Clinical Laboratories, Liverpool University Hospitals Foundation Trust, Liverpool, UK
- National Specialist Ophthalmic Pathology Service (NSOPS), Department of Histopathology, Royal Hallamshire Hospital, Sheffield, UK
- Departments of Pathology and Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Section Ophthalmic Pathology, Department of Pathology, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Pathology, Eye Pathology Section and Ophthalmology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
- Department of Pathology, University of Sydney, Sydney, NSW, Australia
- Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research, Royal North Shore Hospital St Leonards NSW, St Leonards, NSW, Australia
- NSW Health Pathology, Department of Anatomical Pathology, Royal North Shore Hospital, St Leonards NSW, St Leonards, NSW, Australia
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
- Ophthalmic Pathology Service, Asociación para Evitar la Ceguera en México, I.A.P. Faculty of Medicine, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
- Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, MDAnderson Cancer Center, Houston, TX, USA
- Indiana University School of Medicine, Indianapolis, IN, USA
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Tadepalli SH, Shields CL, Shields JA, Honavar SG. Intraocular medulloepithelioma - A review of clinical features, DICER 1 mutation, and management. Indian J Ophthalmol 2019; 67:755-762. [PMID: 31124483 PMCID: PMC6552580 DOI: 10.4103/ijo.ijo_845_19] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Intraocular medulloepithelioma is a nonhereditary neoplasm of childhood arising from primitive medullary epithelium. It most often involves the ciliary body. Most patients present between 2 and 10 years of age with loss of vision, pain, leucocoria, or conjunctival congestion. The mass appears as a grey-white ciliary body lesion with intratumoral cysts. Presence of a neoplastic cyclitic membrane with extension to retrolental region is characteristic. Secondary manifestations like cataract and neovascular glaucoma may be present in up to 50% and 60% patients, respectively. These could be the first signs for which, unfortunately, about 50% patients undergo surgery before recognition of the hidden tumor. Systemic correlation with pleuropulmonary blastoma (DICER1 gene) has been documented in 5% cases. Histopathology shows primitive neuroepithelial cells arranged as cords closely resembling the primitive retina. Histopathologically, the tumor is classified as teratoid (containing heteroplastic elements) and nonteratoid (containing medullary epithelial elements), each of which are further subclassified as benign or malignant. Retinoblastoma-like and sarcoma-like areas may be seen within the tissue. The treatment modality depends on tumor size and extent of invasion. For small localized tumors (≤3-4 clock hours), conservative treatments with cryotherapy, plaque radiotherapy, or partial lamellar sclerouvectomy (PLSU) have been used. Plaque brachytherapy is generally preferred for best tumor control. Advanced and extensive tumors require enucleation. Rare use of intra-arterial and intravitreal chemotherapy has been employed. Systemic prognosis is favorable, but those with extraocular extension and orbital involvement show risk for local recurrence and metastatic disease, which can lead to death.
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Affiliation(s)
- Sameeksha H Tadepalli
- Department of Ocular Oncology, Wills Eye Hospital, Philadelphia, PA, USA; Department of Ocular Oncology, Centre for Sight, Hyderabad, Telangana, India
| | - Carol L Shields
- Department of Ocular Oncology, Wills Eye Hospital, Philadelphia, PA, USA, India
| | - Jerry A Shields
- Department of Ocular Oncology, Wills Eye Hospital, Philadelphia, PA, USA, India
| | - Santosh G Honavar
- Department of Ocular Oncology, Centre for Sight, Hyderabad, Telangana, India
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