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Castro Valley, CA, United States

Char D.H.,Tumori Foundation | Barakos J.A.,California Pacific Medical Center | Moretto J.,California Pacific Medical Center
Orbit | Year: 2010

Orbital cavernous hemangioma usually has a typical clinical and imagery pattern. We present a patient with an enlarged lacrimal gland due to an intra-gland cavernous hemangioma. © 2010 Informa Healthcare USA, Inc.


Milman T.,New York Eye and Ear Infirmary | Milman T.,New York Medical College | Hu D.-N.,New York Eye and Ear Infirmary | Hu D.-N.,New York Medical College | And 11 more authors.
Melanoma Research | Year: 2012

Retinoinvasive uveal melanoma demonstrates prominent diffuse retinal and optic nerve invasion, with little or no involvement of the adjacent choroid. Prior studies have advanced hypotheses on the potential role of molecular and cellular interactions in the pathogenesis of retinoinvasiveness and neuroinvasiveness, but the precise molecular events are not known. Here, we investigate the role of neutrotrophic factors in the pathogenesis of retinoinvasive uveal melanoma. The records of three ophthalmic pathology departments (The New York Eye and Ear Infirmary, Wills Eye Institute, and University of California San Francisco) were searched to identify all cases of retinoinvasive uveal melanoma, yielding four eyes (all previously irradiated). Eight eyes with nonretinoinvasive melanomas (four irradiated and four nonirradiated) were randomly selected as controls. All enucleated eyes were examined histopathologically and immunohistochemically for the expression of neurotrophic factor receptors [Pan-Trk, p75 neurotrophin receptor (p75 NTR) and ciliary neurotrophic factor receptor-a]. Histopathologic features were similar in both retinoinvasive and control melanomas with regard to choroidal tumor location and size, neovascular glaucoma, and cell type. The eyes with retinoinvasive melanoma showed diffuse retinal invasion beyond the choroidal tumor (n= 4) and prelaminar (n= 1) and retrolaminar (n =2) optic nerve invasion. The control melanomas showed focal retinal invasion over the tumor apices (n= 6) and prelaminar optic nerve invasion (n= 1). Nonirradiated melanomas demonstrated no trace immunoreactivity for neurotrophic factor receptors, whereas irradiated melanomas showed more prominent (trace to moderate) immunoreactivity. When controlled for irradiation, no difference in immunoreactivity for neurotrophin receptors nor tumor duration was observed between retinoinvasive and nonretinoinvasive melanomas. This study failed to demonstrate a direct causation between the expression of neurotrophin receptors and a retinoinvasive uveal melanoma growth pattern. Melanoma Res 22:164-168 © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins.


Gill H.S.,University of California at San Francisco | Gill H.S.,Stanford University | Gill H.S.,California Pacific Medical Center | Char D.H.,Tumori Foundation | And 3 more authors.
Canadian Journal of Ophthalmology | Year: 2012

Objective: To review the evidence for molecular genetic testing of uveal melanoma in the context of prognostic indicators of metastasis and tumour-related mortality. Design: Review of the literature and personal experiences of the authors. Methods: We conducted a MEDLINE, Embase, and PubMed literature search (1980-2011) for English-language abstracts and full-text references regarding molecular genetic testing of uveal melanoma. Search terms included uveal, melanoma, cytogenetic, gene, and molecular. All studies in which patients with primary uveal melanoma underwent molecular genetic testing with survival data for disease-related metastasis and mortality were reviewed. Results: From 176 identified articles, 40 were scientific studies of uveal melanomas that included histologic and molecular genetic analysis. Of those, 24 included survival data, correlation of molecular genetic features with other prognostic indicators, or both. Cytogenetic and microarray gene expression analysis allows uveal melanoma lesions to be classified as high risk or low risk for metastasis and disease-related mortality. Gene expression profiling supersedes clinical, histologic, and cytogenetic prognosticators. Conclusions: Uveal melanoma comprises a heterogeneous group of malignancies based on its molecular biology. Molecular class by gene expression profiling has the most strongly predictive value for uveal melanoma metastasis and mortality. © 2012 Canadian Ophthalmological Society.


Jusufbegovic D.,Tumori Foundation | Char D.H.,Tumori Foundation | Char D.H.,University of California at San Francisco | Char D.H.,Stanford University
JAMA Ophthalmology | Year: 2015

IMPORTANCE: Mycosis fungoides (MF) is the most common subtype of cutaneous T-cell lymphoma and may rarely infiltrate the ocular structures. Ophthalmic findings in MF can be highly variable. The most commonly involved ocular tissue is the eyelid skin, but intraocular involvement can be seen in patients with extensive systemic disease. To our knowledge, an isolated eyelid mass as an initial manifestation of MF has not been previously reported. OBSERVATIONS: We report a series of 4 cases of ocular involvement in patients with MF demonstrating a highly variable ophthalmic presentation of this disease. The development of an isolated eyelid mass was an initial manifestation of MF in 1 of the patients. Isolated anterior uveitis, vitritis, and choroidal mass are described in 3 patients with aggressive systemic disease. CONCLUSIONS AND RELEVANCE: Infiltration of the ocular structures by MF is rare, but the involvement of different ocular tissues and a highly variable clinical presentation can be seen. Eyelid lesion may be an initial manifestation of MF. These cases suggest that intraocular involvement occurs in patients with aggressive systemic disease and usually portends a poor prognosis for survival. Copyright 2015 American Medical Association. All rights reserved.


Char D.H.,Tumori Foundation | Char D.H.,Stanford University | Cole T.B.,Tumori Foundation | Miller T.R.,University of California at San Francisco
Orbit | Year: 2012

Orbital fine needle aspiration biopsy is a useful diagnostic adjuvant. In this case, an FNAB showed lymphocytes. The surgeon felt that this diagnosis was possibly inaccurate, and therefore took out the tumor en bloc. This was a mucoepidermoid carcinoma involving the lacrimal gland that had been heavily infiltrated by lymphocytes. © 2012 Informa Healthcare USA, Inc.

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