Subconjunctival Ocular Argyrosis following Treatment with Ruthenium 106 Brachytherapy for Choroidal Melanoma.
Brachytherapy
Conjunctival pigmentation
Ocular argyrosis
Ruthenium
Uveal melanoma
Journal
Ocular oncology and pathology
ISSN: 2296-4681
Titre abrégé: Ocul Oncol Pathol
Pays: Switzerland
ID NLM: 101656139
Informations de publication
Date de publication:
Sep 2023
Sep 2023
Historique:
received:
24
02
2023
accepted:
17
05
2023
pmc-release:
01
09
2024
medline:
4
12
2023
pubmed:
4
12
2023
entrez:
4
12
2023
Statut:
ppublish
Résumé
Ruthenium-106 (Ru-106) brachytherapy is one of the commonest eye-sparing treatments for choroidal melanoma. These patients require long-term surveillance of the treated tumour remnant to ensure there is no local recurrence. New or progressive pigmented lesions in treated eyes are often regarded as suspicious - especially if there are concerns of extra-scleral extension. We present two cases of posterior choroidal melanoma treated five and 10 years previously with Ru-106. Both cases developed subconjunctival dark/black lesions on the anterior surface of the eye in the quadrant of the conjunctival peritomy during Ru-106 treatment. Both had similar findings on histopathology: black, non-organic, particulate foreign material of varying confluence deposited on elastin and collagen fibres. Energy dispersive X-ray microanalysis confirmed the material contained silver. The Ru-106 applicator consists of a radioactive core of Ru-106 encapsulated within pure silver as a radiation shield. During surgical insertion, stainless steel suture needles and forceps can occasionally scratch the applicator's silver eyelets and scatter microscopic particles of elemental silver into the operative field. These particles were likely deposited within the subconjunctival tissues of these patients during brachytherapy administration, leading to localised ocular argyrosis. Iatrogenic ocular argyrosis should be considered in the differential diagnosis of new pigmented lesions in patients treated with Ru-106 brachytherapy. This study is the first to unequivocally identify the cause of some post-brachytherapy ocular surface pigmentation as caused by silver.
Identifiants
pubmed: 38046271
doi: 10.1159/000531385
pii: 531385
pmc: PMC10689982
doi:
Types de publication
Case Reports
Langues
eng
Pagination
101-106Informations de copyright
© 2023 S. Karger AG, Basel.
Déclaration de conflit d'intérêts
There are no conflicts of interest to declare.
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