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Aim: Describe the results of brachytherapy in the prevention of recurrences in conjunctival melanoma (CM) and describe a dosimetric protocol., Methods: Retrospective and descriptive case report. Eleven consecutive patients with a confirmed histopathological diagnosis of CM treated with brachytherapy between 1992 and 2023 were reviewed. Demographic, clinical, and dosimetric characteristics as well as recurrences were recorded. Quantitative variables were represented by the mean, median, and standard deviation, and qualitative variables by frequency of distribution., Results: Of a total of 27 patients diagnosed with CM, 11 who were treated with brachytherapy were included in the study (7 female; mean age at time of treatment: 59.4 years). Mean follow-up was 58.82 months (range 11-141 months). Of a total of 11 patients, 8 were treated with ruthenium-106 and 3 with iodine-125. Brachytherapy was performed in 6 patients as adjuvant therapy after biopsy-proven CM on histopathology and in the other 5 patients after recurrence. The mean dose was 85 Gy in all cases. Recurrences outside of the previously irradiated area were observed in 3 patients, metastases were diagnosed in 2 patients, and one case of an ocular adverse event was reported., Conclusion: Brachytherapy is an adjuvant treatment option in invasive conjunctival melanoma. In our case report, only one patient had an adverse effect. However, this topic requires further research. Furthermore, each case is unique and should be evaluated by experts in a multidisciplinary approach involving ophthalmologists, radiation oncologists, and physicists., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Competing Interests: The authors declare no interests.

Macroscopic study of surgical samples sent to the histopathology lab provides the first diagnostic approach. Obtaining quality photographs of these pieces facilitates proper case documentation for publication, sharing, teaching and research.This device has been originally designed for enucleated eyes but it could be used for a wide diversity of human or animal samples including thyroids, pituitary glands, prostates… It can be coupled to any smartphone camera.The Black and White Box is an affordable and easy option for taking gross pathology photographs of high quality. In this work we provide full instructions on how to make it., (© 2019 Wiley Periodicals, Inc.)

Purpose: To assess the long-term influence of radiobiological doses in the evolution of visual acuity (VA) in patients with uveal melanoma treated by episcleral brachytherapy., Material and Methods: Visual acuity was evaluated prospectively from a case series of 243 patients in 2016 treated with 125 I. Data analysis was applied to trend VA outcome and find the accurate best-fit line. Biologically effective dose (BED) was included in survival analysis with the use of Kaplan-Meier and Cox regressions. Hazard ratio (HR) and confidence interval at 95% (CI) were determined. Variables statistically significant were analyzed and compared by log-rank tests., Results: The median follow-up was 74.2 months (range, 3-223). Exponential regression shows a 25% reduction and 50% in visual acuity score (VAS) scale for 5 and 27.8 months, respectively. Cumulative probabilities of survival analysis were 57%, 42%, 27%, and 23% at 3, 5, 10, and 15 years, respectively. Multivariable analysis found tumor height (HR = 1.18, 95% CI: 1.07-1.29), applicator size (HR = 1.22, 95% CI: 1.08-1.36), juxtapapillary localization (HR = 1.70, 95% CI: 1.01-2.84), and dose to foveola (HR = 1.01, 95% CI: 1.00-1.01) significantly associated with VA loss. Log-rank tests were significant for all those variables. BED has a strong influence in univariate model, but not statistically significant in the multivariate one., Conclusions: Visual acuity changes can be modeled by an exponential function for the first 5 years after treatment. No relation between VA loss and BED has been found; nevertheless, apical height, plaque size, juxtapapillary localization, and dose to fovea were found as statistical significant variables.

Purpose: To describe the time, frequency, and clinical characteristics of treatment failure after I-125 brachytherapy in patients with uveal melanoma treated and followed in a Spanish referral ocular oncology unit., Design: Prospective, consecutive, interventional case series., Methods: Patients diagnosed with uveal melanoma from 1995 to 2016 and treated with episcleral brachytherapy were included. Demographic data collection, ophthalmic evaluation, ultrasound scan, and systemic studies were performed at baseline, every 6 months thereafter for 5 years, and subsequently at annual intervals. Recurrence was defined as presence of tumor growth after treatment. Baseline analysis was performed by descriptive methods and survival by Kaplan-Meier curves., Results: From 732 patients diagnosed with uveal melanoma, 311 were treated with brachytherapy. In the follow-up (mean 79 months, standard deviation = 55), 16 local tumor recurrences (5.1%) were detected. All relapsing patients had choroidal tumors and 15 presented with visual symptoms. All patients were treated with I-125 brachytherapy, and 2 received associated transpupillary thermotherapy. All the eyes were enucleated after recurrence. Kaplan-Meier analysis showed a mean time of recurrence of 3.7 years (standard deviation = 2.94 years, ranging from 1 to 12 years). Three patients had metastasis in the follow-up. Kaplan-Meier analysis showed worse survival for patients with recurrence., Conclusion: Local treatment failure was a relatively infrequent event after I-125 brachytherapy in our series. Recurrences appear not only early but also late in the follow-up. They do not have a distinctive clinical pattern and are associated with poorer survival., (Copyright © 2017 Elsevier Inc. All rights reserved.)

A 68-year-old man diagnosed with choroidal melanoma (CM) in the right eye underwent treatment with episcleral brachytherapy (I125) and transpupillary thermotherapy. Ultrasound, computed tomography, and magnetic resonance imaging were performed and revealed ocular recurrence of CM. Treatment with extended enucleation was performed. Macroscopic and microscopic examinations revealed extraocular extension and malignant cells, respectively. Immunohistochemistry demonstrated tumoral Melan-A and HMB-45 expression. No cytogenic abnormalities were detected with fluorescence in situhybridization of tumor cells using probes against chromosomes 3q27 and 8q24. The patient underwent adjuvant external beam radiotherapy for treatment of residual tumor tissue. This case represents the first reported case of recurrent CM with no cytogenetic abnormalities and the absence of metastatic disease, despite a number of the poorest prognostic factors.

Rhabdomyosarcoma is a rare tumor, with an annual incidence of 4.3 cases per million children. Even thought, it is the most common soft tissue sarcoma in childhood, with a mean age of 6 to 8 years at diagnosis. A 4 year-old boy presented with a history of a fast growing (1-month) nodular lesion in the caruncle of his left eye. Slit lamp examination showed a vascularized solid nodular lesion in the semilunar fold. The lesion was surgically removed obtaining infiltrated edges with tumoral cells. A second surgery was performed with free tumour edges. The diagnosis of embryonal rhabdomyosarcoma, botryoid type, of intermediate differentiation was made. The treatment for botryoid rhabdomyosarcoma is basically surgical with the combined use of adjuvant polychemotherapy. In adolescent or adult patients (not in infants where growth bone disturbances can occur) external beam radiotherapy can be combined with chemotherapy. Rhabdomyosarcomas of the conjunctiva without orbital extension are rarely reported. We presented a case of a child with a rare tumor which we had a high suspicion of malignancy and early diagnosis and treatment and child is free of systemic disease 6 and half years later. Our research group believes that the key in these tumors is the high index of suspicion and early treatment.

Objectives: To estimate the prevalence of domestic violence (DV) in adult women attending Primary Care medical consultations, to determine the associated factors, and family physician involvement in its detection., Material and Methods: We performed a cross-sectional analytical study in two urban health districts of Santa Cruz de Tenerife, Canary Islands. A consecutive sample of women aged 18 or older, whether or not they had a current partner were selected.. The Bradley questionnaire, which is validated (26 items) and assesses physical, psychological and sexual violence was used anonymously. Demographic characteristics, and those related to the couple, health history, presence of anxiety and depression (Goldberg scale) were recorded., Results: A total of 299 women were interviewed, and 154 women recognised some kind of abuse at least once in their life (51.5%, 95% Cl: 40%-62%). Psychological violence was the most mentioned (n = 153; 99.35%), followed by physical (n = 39; 25.32%) and sexual violence was stated by 12 women (7.79%). Domestic violence was associated with: younger age, less time in a previous relationship, lack of social support (OR=2.18, P=.019), presence of probable anxiety (OR = 1.77, P = .015) and probable depression (OR = 1.58, P = .049). After multivariate analysis the association persisted with the Length of time of the relationship with previous partner (OR = 0.998; P < .0001) and the presence of probable anxiety (OR = 1.79; P = .024). Early detection of domestic violence was recorded in the medical records of 111 women (37.1%; 95% CI: 36.90-37.23)., Conclusions: As in other studies, DV is associated with mental disorders, and there is a need for greater involvement by family physicians to detect this prevalent problem in our clinics.

Objective: to analyze ocular survival in eyes with uveal melanoma treated with conservative therapies, in a centre that applies all treatment modalities., Methods: Patients diagnosed with uveal melanoma and treated between September 1990 and April 2007 were included in an historical cohorts study., Results: 273 patients were included. 193 were treated with conservative treatments (70.69%) and 80 were enucleated as primary treatment. 14 patients were enucleated after conservative treatment (7.2%). Kaplan-Meier survival analysis showed an 88% survival probability of the eye in the first 5 years after conservative treatment and 83% at 10 years., Conclusions: Conservative treatments for uveal melanoma, especially brachitherapy, are safe and effective in relation to tumor control and rate of secondary effects.

A retrospective epidemiological and histopathological review was made of 258 patients. Forty had laryngeal polyps, 35 vocal fold nodules, and 41 Reinke edema. One hundred forty-two records were excluded for lack of epidemiological or histopathological data. No dysplastic changes were observed in nodules or polyps. One patient with edema had mild dysplasia. The epidemiological data showed that voice abuse or misuse was the main factor in patients with vocal fold nodules; smoking was the main factor in polyps and edema.