Uveal melanoma physical examination: Difference between revisions

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{{Uveal melanoma}}
{{Uveal melanoma}}
{{CMG}}{{AE}}{{Simrat}}
 
{{CMG}}; {{AE}} {{Fs}}
 
==Overview==
==Overview==
Common physical examination findings of uveal melanoma include presence of dark spot on the [[iris]], anisicoria, loss of [[peripheral vision]], decreased [[visual acuity]] and [[photopsia]].
Patients with uveal melanoma usually appear normal. Physical examination of [[Patient|patients]] with uveal melanoma is usually remarkable for [[Ophthalmology|ophthalmologic]] findings of melanoma.
 
==Physical Examination==
==Physical Examination==
===Appearance of the Patient===
*[[Patients]] with uveal melanoma usually appear normal.
===Vital Signs===
*[[Patients]] with uveal melanoma usually present with normal [[vital signs]].
===Skin===
*[[Skin]] examination of [[patients]] with uveal melanoma is usually normal.<ref name="AlbertSearl1983">{{cite journal|last1=Albert|first1=Daniel M.|last2=Searl|first2=Steven S.|last3=Forget|first3=Bernadette|last4=Lavin|first4=Philip T.|last5=Kirkwood|first5=John|last6=Nordlund|first6=James J.|title=Uveal Findings in Patients with Cutaneous Melanoma|journal=American Journal of Ophthalmology|volume=95|issue=4|year=1983|pages=474–479|issn=00029394|doi=10.1016/0002-9394(83)90267-2}}</ref>
*[[Skin]] [[nevus]] or melanoma
===HEENT===
===HEENT===
*Dark spot is present on the [[iris]]
*Anisicoria
*Loss of [[peripheral vision]]
*Decreased [[visual acuity]]
*[[Photopsia]]
*[[Visual field]] tests
The ophthalmologist uses the following instruments to look inside the eye for a [[tumor]]:
*An ophthalmoscope (also known as a direct ophthalmoscope).
*An [[indirect ophthalmoscope]] and a slit lamp is more like a large microscope.
*A [[gonioscopy]] lens.
Diagnosis of uveal melanoma is based on a combination of clinical examination with indirect ophthalmoscopy, [[slit lamp]] biomicroscopy, and [[ultrasonography]]
*Iris melanomas are detectable by slit lamp biomicroscopy, on the other hand [[ciliary body]] [[tumors]] are hidden behind the iris and can be visualized by ultrasonography. Depending on their location, choroidal tumours, are diagnosed by dilated indirect ophthalmoscopy and ultrasonography.
*Indirect ophthalmoscopy through a dilated pupil provides a correct diagnosis in more than 95% of the cases. Accuracy of the correct diagnosis is established to be over 99% by experienced clinicians with [[ophthalmoscopy]], [[ultrasound]], and [[fluorescein angiography]] and confirmed by histopathology.<ref name="vanKoopmans2013">{{cite journal|last1=van|first1=J.G.M.|last2=Koopmans|first2=A.E.|last3=Verdijk|first3=R.M.|last4=Naus|first4=N.C.|last5=de|first5=A.|last6=Kilic|first6=E.|title=Diagnosis, Histopathologic and Genetic Classification of Uveal Melanoma|year=2013|doi=10.5772/53631}}</ref>
*The clinical diagnosis of uveal melanoma can be made on dilated fundus exam when the classical appearance of a pigmented dome shaped mass extends from the ciliary body or choroid indicating that the tumor has extended through [[Bruch’s membrane]]. Approximately 20% of lesions will take on a large, mushroom shape.
The appearance of melanoma depends on its location and size, whether it is in the [[iris]] or the [[choroid]].
*Iris melanoma appears as a brown or yellow nodule on the iris. It is usually visible to the patient.
*Choroidal melanoma appears as a  yellow or brown or tumor in the back of the eye and is not visible to the patient.
== References ==


{{reflist|2}}
* Evidence of [[trauma]]
{{WikiDoc Help Menu}}
*[[Pupils]] reactive to light and reactive to accommodation
{{WikiDoc Sources}}
*Ophthalmoscopic exam may be abnormal with findings of :
[[Category:Disease]]
**[[Iris]] [[melanoma]]:
[[Category:Ophthalmology]]
***Circumscribed nodule mostly in the inferior half of the [[iris]]
***Different in size
***Yellow or brown in color
**Chroidal [[melanoma]]:
***Nodular [[mass]] under the [[Retinal pigment epithelium|retinal pigment]]
***Diffuse with less elevation
***Abnormal vascularization
**[[Ciliary body]] melanoma:
***Sentinel vessel
***Unilateral low [[intraocular pressure]]
 
===Neck===
*[[Neck]] examination of [[patients]] with uveal melanoma is usually normal.
 
===Lungs===
*[[Pulmonary]] examination of patients with uveal melanoma is usually normal.
 
===Heart===
*[[Cardiovascular]] examination of patients with uveal melanoma is usually normal.
 
===Abdomen===
*[[Abdominal]] examination of patients with uveal melanoma is usually normal.
 
===Back===
* Back examination of patients with uveal melanoma is usually normal.
 
===Genitourinary===
*[[Genitourinary]] examination of patients with uveal melanoma is usually normal.
 
===Neuromuscular===
*[[Neuromuscular]] examination of patients with uveal melanoma is usually normal.
 
===Extremities===
*[[Extremities]] examination of patients with uveal melanoma is usually normal.
 
==References==
{{Reflist|2}}
 
{{WH}}
{{WS}}
[[Category: (name of the system)]]

Latest revision as of 03:35, 19 August 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

Overview

Patients with uveal melanoma usually appear normal. Physical examination of patients with uveal melanoma is usually remarkable for ophthalmologic findings of melanoma.

Physical Examination

Appearance of the Patient

  • Patients with uveal melanoma usually appear normal.

Vital Signs

Skin

HEENT

  • Evidence of trauma
  • Pupils reactive to light and reactive to accommodation
  • Ophthalmoscopic exam may be abnormal with findings of :

Neck

  • Neck examination of patients with uveal melanoma is usually normal.

Lungs

  • Pulmonary examination of patients with uveal melanoma is usually normal.

Heart

  • Cardiovascular examination of patients with uveal melanoma is usually normal.

Abdomen

  • Abdominal examination of patients with uveal melanoma is usually normal.

Back

  • Back examination of patients with uveal melanoma is usually normal.

Genitourinary

  • Genitourinary examination of patients with uveal melanoma is usually normal.

Neuromuscular

  • Neuromuscular examination of patients with uveal melanoma is usually normal.

Extremities

  • Extremities examination of patients with uveal melanoma is usually normal.

References

  1. ↑ Albert, Daniel M.; Searl, Steven S.; Forget, Bernadette; Lavin, Philip T.; Kirkwood, John; Nordlund, James J. (1983). "Uveal Findings in Patients with Cutaneous Melanoma". American Journal of Ophthalmology. 95 (4): 474–479. doi:10.1016/0002-9394(83)90267-2. ISSN 0002-9394.

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