DISTRIBUTION OF PROGNOSTICALLY IMPORTANT VASCULAR PATTERNS ACROSS MULTIPLE LEVELS IN CILIARY BODY AND CHOROIDAL MELANOMAS

PURPOSE: To investigate the validity of assigning patients whose eyes have been removed for ciliary body or choroidal melanoma to risk group s for metastasis based on the identification of microcirculatory patte rns in one cross-section taken from the center of the tumor. METHODS: Multiple levels were cut through the blocks of 15 ciliary body or chor oidal melanomas until the tumor was exhausted. Each level was examined for the presence of microvascular networks and parallel vessels with cross linking histologic features strongly associated with death from metastatic melanoma. RESULTS: The central histologic section did not c ontain either microvascular networks or parallel vessels with cross-li nking in eight tumors, nor were these patterns encountered in any of t he more peripheral levels of the tumor. Seven tumors contained at leas t one focus of either microvascular networks or parallel vessels with cross-linking in the central histologic section. In two tumors, at lea st one of these patterns appeared in all histologic levels; in five tu mors, at least one of these patterns appeared through multiple levels until just before the tumor was exhausted from the block (0.24 to 0.85 mm from the edge of the tumor). CONCLUSIONS: This study suggests that the prognostic classification of uveal melanoma based on the histolog ic profile of the microcirculation may be consistent throughout the tu mor depth, (C) 1998 by Elsevier Science Inc. All rights reserved.