Uncommon Nonetheless , Possible Etoposide Strategies

The mean age at surgery was 2.45 years, and the mean duration of symptoms (primarily leukocoria) was 10.61 months. This means that diagnosis and treatment was delayed, and most of these patients, of whom 23.0% were bilateral, were enucleated at an advanced stage of disease. Of all the children enucleated with a clinical diagnosis of retinoblastoma, 95.7% were histologically proven correct and only 4.3% turned out to be pseudoretinoblastomas. This rate of clinical accuracy is comparable with the best centers in the world.10 In adults, uveal melanomas were the most common intraocular malignancies seen. Melanomas are much more prevalent in Caucasian populations and are rare in more pigmented individuals. In our series, there was an average of three cases per year with a mean patient age of 48.37 years and slight predominance in females. This is different from reports from other countries.2 In the Armed Forces Institute of Pathology (AFIP) registry the Autophagy patients had a median age of 53 years and were predominantly male;11 racial differences and variations in natural pigmentation may be the reason for the discrepancy. It is a consensus among all reports that the four most common malignancies involving the eyelids are BCC, SCC, SGC, and melanoma; however their relative frequencies differ. BCC is usually the most common and accounts for more than 80% of eyelid malignancies in Singapore12 and the USA,13 probably due to high excision rates for suspicious skin lesions. Our finding of 30.6% is similar to reports from Japan14 and India.15 SGC are relatively rare in Caucasian populations but are more common in Asians. In our series SGC was tied with BCC at 30.6% �C a figure similar to those reported in India and People��s Republic of China.16 It was more common in women in our series, similar to other reports from Asia.4,12 The proportion of malignant melanomas seen was surprisingly high, at 11.8% of all eyelid cancers. This is a condition more commonly seen in Caucasians and less in pigmented people. The seemingly disproportionate number of melanomas may be due to the fact that the PGH DOVS is a referral center for difficult cases from all over the country, and affected patients are sent there by ophthalmologists who lack experience with the condition. In the same vein, the number of BCC might have been small because these are slow-growing, nonaggressive tumors that are tolerated by patients and can be managed at primary and secondary centers. The most common site of SCC in the eye and ocular adnexa was the conjunctiva, and this was confirmed by several reports. In our series, SCC accounted for 40.4% of all conjunctival malignancies and was seen in patients with a mean age of 62.48 years. Almost twice as many men were affected, probably due to increased occupational sun exposure. The next lesion most commonly diagnosed (26.3%) histologically was CIN, the premalignant precursor of SCC, with patients having a younger mean age of 56.