Internal Medicine

0521779407-10 CUNY1086/Karliner 0 521 77940 7 June 6, 2007 17:44

860 Intraocular Tumors Intravascular, Non-Immune Hemolytic Anemia

■If necessary, intraocular FNAB is definitive in primary and metastatic

tumors.

management

■∼80% of intraocular melanoma eyes can be salvaged, often with good

vision.

■Treatments include laser, radiation, (brachytherapy, protons, or

IMCT), removal of the tumor with retention of the eye, and enu-

cleation.

■Metastases from uveal melanoma have a predilection for the liver.

■Uveal melanoma patients screened with serum LDH, GGT, CT/PET

scan

■Metastases to the eye treated with chemotherapy or radiation; rarely

a solitary lesion is amenable to brachytherapy or laser.

■∼33% of metastases to the eye have simultaneous CNS metastases;

brain MRI with contrast

specific therapy

n/a

follow-up

■Depending on histology, and potential for effective therapy, meta-

static evaluation accordingly.

■Retinoblastoma (Rb) virtually never presents in adults; bilateral Rb

survivors pass the disease in an autosomal dominant manner.

■Molecular gene testing, especially in familial Rb disease, is quite

accurate.

■More bilateral Rb children die from a second malignancy than Rb in

the USA.

■Bilateral Rb survivors require constant vigilance for second tumors.

complications and prognosis

n/a

INTRAVASCULAR, NON-IMMUNE HEMOLYTIC ANEMIA –

MICROANGIOPATHIC HEMOLYTIC ANEMIAS

CHRISTINE CSERTI, MD; FRANK J. STROBL, MD; JONATHAN KURTIS, MD, PhD;

and LESLIE SILBERSTEIN, MD

history & physical

History

■premature destruction of circulating red blood cells via direct

mechanical, lytic, oxidizing, or thermal forces (see Differential Diag-

nosis)