Clinical and histomorphological characteristics of medium and large-sized uveal melanoma stages T1 – 3 after failure of organ-preserving treatment

Abstract

To assess the effectiveness of the developed combined method of Transpupillary ThermoTherapy (TTT) and Strontium-90/Yttrium-90Brachytherapy (BT) for Uveal Melanoma (UM), it is advisable to know the features of therapeutic pathomorphosis in tumor tissue.Aim.To evaluate the effectiveness of the Institute's treatment method for uveal melanoma based on the study of the histomorphological features of therapeutic pathomorphosis.Materials and Methods. Fifteen enucleated eyes with continued growth of medium and large-sizedUMs of stage T1–3 were studied, after the combined action of TTT and BT Sr-90/Y-90 according to the developed methodology, which was carried out at the State Institution "The Filatov Institute of Eye Diseases and Tissue Therapy of NAMS of Ukraine". The studied objects (eyeballs) were fixed in 10% neutral formalin solution, embedded in paraffin and histological sections [10–12] μm thick were made, which were stained with Harris hematoxylin and eosin and studied on a Jenamed-2light microscope at objective magnificationfrom 4× to 40× and eyepiece magnification of 10× followed by photoregistration with a digital video camera and assessment of therapeutic pathomorphosis.The study was conducted as part of the topic with state registration number 01224U00149.Research Ethics.The study was conducted without human participation and did not require approval by the ethics committee.Results.The removed melanomas were mainly mixed cell -14 (93.3%) out of 15, one was epithelioid cell. Among mixed cell melanomas with a predominance of spindle cells, there were 3 (21.4%), epithelioidcells –4 (28.6%). Tumors had pigmentation of varying degrees in 13 cases (86.7%), in 2 cases (13.3%)the melanoma was amelanotic. Invasion to the episclera was established in 6 cases (40.0%), the formationof an extrabulbar node –in 4 (26.7%), while the extrabulbar node was not clinically detected in 2 cases.Among the 15 melanomas studied, grade I therapeutic pathomorphosis was detected in 2, the II degree –in 3, the II–III degree –in 8 melanomas, in 2cases there were no manifestations of pathomorphosis.Conclusions.Therapeutic pathomorphosis after combined TTT and Sr-90/Y-90 brachytherapy wasobserved in 13 of 15 cases. The treatment method itself is not the primary cause of treatment failure; comparison with successfully treated cases is not feasible due to the absence of enucleation material. This study defines the limitations of the method rather than questioning its overall effectiveness.

Для оцінки ефективності розробленої методики комбінованої дії транспупілярної термотерапії (ТТТ) та брахітерапії (БТ) Sr-90/Y-90 на увеальну меланому(УМ) доцільно знати особливості лікувального патоморфозу в тканині пухлини.Мета. Оцінити ефективність методу лікування увеальної меланоми, розробленого вІнституті ім. В.П. Філатова,шляхомвивчення гістоморфологічнихособливостей терапевтичного патоморфозу. Для оцінки ефективності розробленої методики комбінованої дії транспупілярної термотерапії (ТТТ) та брахітерапії (БТ) Sr-90/Y-90 на увеальну меланому(УМ) доцільно знати особливості лікувального патоморфозу в тканині пухлини.Мета. Оцінити ефективність методу лікування увеальної меланоми, розробленого вІнституті ім. В.П. Філатова,шляхомвивчення гістоморфологічнихособливостей терапевтичного патоморфозу.