PMC4966167_01
Radiology and histopathology (A) Axial CT orbits showed a dome-shaped hyperdense lesion in the left eye with calcification along the anterolateral margin. (B) Axial MRI of the head with gadolinium showed a T2 hypointense lesion measuring 11.6-mm width, 6.3-mm height. (C) Ultrasound showed calcified mass 6.49 mm in height. H&E stain showed tumour confined to globe (D) and predominantly epithelioid cell morphology (E) 40x (F) 60x bleached (G) 60x unbleached. (H) Tumour stained with antibody to melanocytic marker, Mart-1.
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F1
CT orbits showed a left ocular hyperdense calcified dome-shaped lesion (figure 1A). MRI showed that the 11.6-mm widthx6.3-mm height mass was T1-hyperintense (not shown) and T2-hypointense (figure 1B), and ultrasonography showed a large calcified lesion (figure 1C). The melanocytic tumour, confined to the left globe (figure 1D), occupied the choroid and showed predominantly epithelioid histology, consisting of large, irregular, polygonal cells with prominent nuclei, abundant cytoplasm and varying levels of pigmentation (figure 1E-G), fitting the Callender classification. It was positive for the melanocytic marker Mart-1 (figure 1H), showed few mitotic figures and low MIB-1 staining, with no necrosis, vasculogenic mimicry nor extension into sclera or optic nerve.
Gene Expression Profiling Principal Component Analysis (PCA) of the uveal melanoma against previously analysed and validated tumours. Spheres with asterisks=Class 1 gene expression signature with favourable prognosis; Black spheres=Class 2 gene expression signature with less favourable prognosis; Grey sphere=our patient's uveal melanoma, which co-localises with the favourable-prognosis tumours with Class 1 gene expression signature. This figure is only reproduced in colour in the online version.
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F2
Gene expression profiling revealed a low-risk Class 1 gene expression signature (figure 2).