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September 1979, Vol 97, No. 9 >
ARTICLE | September 1979

Balloon Cell Melanomas of the Ciliary Body FREE

Frederick A. Jakobiec, MD; Jerry A. Shields, MD; Laurence Desjardins, MD; Takeo Iwamoto, MD
[+] Author Affiliations

Accepted for publication Nov 1, 1978.

Reprint requests to the Manhattan Eye, Ear, and Throat Hospital, 210 E 64th St, New York, NY 10021 (Dr Jakobiec).


Arch Ophthalmol. 1979;97(9):1687-1692. doi:10.1001/archopht.1979.01020020255014
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References
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• In spite of the fact that balloon cell change has been recognized ophthalmoscopically and histologically in certain posterior choroidal melanomas, the nature and importance of this observation remain controversial. This article provides a clinicopathologic correlation in two cases of ciliary body melanoma with almost total balloon cell transformation. On the basis of special stains and electron microscopic observations, we have concluded that balloon cells in such cases represent spindle melanoma cells that have undergone extensive cytoplasmic lipid metamorphosis. The possible mechanisms for this change are considered. Melanomas containing an abundant number of balloon cells are probably comparatively dormant and benign tumors that offer a relatively good prognosis. Although clinical recognition may be difficult, the use of needle biopsy coupled with cytologic diagnosis in selected ciliary body tumors may disclose balloon cell change and help to direct therapy.

REFERENCES

1 +
Riley FC:  Balloon cell melanoma of the choroid . Arch Ophthalmol 92:131-133, 1974;.
2 +
Rodrigues MM, Shields JA:  Malignant melanoma of the choroid with balloon cells: A clinicopathologic study of three cases . Can J Ophthalmol 11:208-216, 1976;.
3 +
Font RL, Zimmerman LE, Armaly MF:  The nature of the orange pigment over a choroidal melanoma: Histochemical and electron microscopical observations . Arch Ophthalmol 91:359-362, 1974;.
4 +
Shields JA, Rodrigues MM, Sarin LK, et al:  Lipofuscin pigment over benign and malignant choroidal tumors . Trans Am Acad Ophthalmol Otolaryngol 81:871-881, 1976;.
5 +
Font R:  Electron microscopy of tumors of the eye and ocular adnexa , in Reese AB (ed): Tumors of the Eye . New York, Harper & Row Publishers, 1976;, pp 351-366.
6 +
Shields J, Hagler W, Federman J, et al:  The significance of the 32P uptake test in the diagnosis of posterior uveal melanomas . Trans. Am Acad Ophthalmol Otolaryngol 79:297-306, 1975;.
7 +
Schrader W, Helwig E:  Ballon cell nevi . Cancer 20:1502-1514, 1967;.
8 +
Pfaffenbach DD, Green WR, Maumenee AE:  Balloon cell nevus of the conjunctiva . Arch Ophthalmol 87:192-195, 1972;.
9 +
Jao W, Fretzin D, Sundaran L, et al:  Balloon cell nevus of the conjunctiva . Arch Pathol 96:124-126, 1973;.
10 +
Hashimoto K, Bah G:  Electron microscopic study of balloon cell nevus . Cancer 30:530-540, 1972;.
11 +
Ranchod M:  Metastatic melanoma with balloon cell changes . Cancer 30:1006-1013, 1972;.
12 +
Okun M, Donnellan B, Edelstein L:  An ultrastructural study of balloon cell nevus . Cancer 34:615-625, 1974;.
13 +
Roth S:  The ultrastructure of primary water clear hyperplasia of the parathyroid glands . Am J Pathol 61:233-248, 1970;.
14 +
Jakobiec FA, Font R, Johnson F:  Angiomatosis retinae: An electron microscopic study with lipid analysis . Cancer 38:2042-2056, 1976;.
15 +
Nicholson D, Green W, Kenyon K:  Light and electron microscopic study of early lesions in angiomatosis retinae . Am J Ophthalmol 82:193-204, 1976;.
16 +
Jakobiec FA, Font R, Iwamoto T: Diagnostic ultrastructural pathology of ophthalmic tumors, in Jakobiec FA (ed): Ocular and Adnexal Tumors. Birmingham, Ala, Aesculapius, to be published.
17 +
Silvers D, Becker L, Hiles E:  Epidermal melanocytes in eruptive xanthomas . Arch Dermatol 107:847-852, 1973;.
18 +
Kenyon K:  Ocular ultrastructure of inherited metabolic disease , in Goldbery M (ed): Genetic and Metabolic Eye Disease . Boston, Little Brown & Co, 1974;, pp 139-186.
19 +
Cogan DG, Kuwabara T:  The sphingolipidoses and the eye . Arch Ophthalmol 79:437-452, 1968;.
20 +
Kenyon KR, Sensenbrenner JA:  Mucolipidosis II (I—cell disease): Ultrastructural observations of conjunctiva and skin . Invest Ophthalmol 10:555-567, 1971;.
21 +
Brownstein S, Meagher-Villemure K, Polomeno RC, et al:  Optic nerve in globoid leukodystrophy (Krabbe's disease): Ultrastructural changes . Arch Ophthalmol 96:864-870, 1978;.
22 +
Shields JA, Annesley W, Totino J:  Nonfluorescent malignant melanoma of the choroid diagnosed with the radioactive phosphorus uptake test . Am J Ophthalmol 79:634-640, 1975;.
23 +
Jakobiec FA, Chattock A:  The role of cytology and needle biopsies in the diagnosis of ophthalmic tumors and simulating conditions , in Jakobiec FA (ed): Ocular and Adnexal Tumors . Birmingham, Ala, Aesculapius, 1978;, pp 341-358.

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1 +
Riley FC:  Balloon cell melanoma of the choroid . Arch Ophthalmol 92:131-133, 1974;.
2 +
Rodrigues MM, Shields JA:  Malignant melanoma of the choroid with balloon cells: A clinicopathologic study of three cases . Can J Ophthalmol 11:208-216, 1976;.
3 +
Font RL, Zimmerman LE, Armaly MF:  The nature of the orange pigment over a choroidal melanoma: Histochemical and electron microscopical observations . Arch Ophthalmol 91:359-362, 1974;.
4 +
Shields JA, Rodrigues MM, Sarin LK, et al:  Lipofuscin pigment over benign and malignant choroidal tumors . Trans Am Acad Ophthalmol Otolaryngol 81:871-881, 1976;.
5 +
Font R:  Electron microscopy of tumors of the eye and ocular adnexa , in Reese AB (ed): Tumors of the Eye . New York, Harper & Row Publishers, 1976;, pp 351-366.
6 +
Shields J, Hagler W, Federman J, et al:  The significance of the 32P uptake test in the diagnosis of posterior uveal melanomas . Trans. Am Acad Ophthalmol Otolaryngol 79:297-306, 1975;.
7 +
Schrader W, Helwig E:  Ballon cell nevi . Cancer 20:1502-1514, 1967;.
8 +
Pfaffenbach DD, Green WR, Maumenee AE:  Balloon cell nevus of the conjunctiva . Arch Ophthalmol 87:192-195, 1972;.
9 +
Jao W, Fretzin D, Sundaran L, et al:  Balloon cell nevus of the conjunctiva . Arch Pathol 96:124-126, 1973;.
10 +
Hashimoto K, Bah G:  Electron microscopic study of balloon cell nevus . Cancer 30:530-540, 1972;.
11 +
Ranchod M:  Metastatic melanoma with balloon cell changes . Cancer 30:1006-1013, 1972;.
12 +
Okun M, Donnellan B, Edelstein L:  An ultrastructural study of balloon cell nevus . Cancer 34:615-625, 1974;.
13 +
Roth S:  The ultrastructure of primary water clear hyperplasia of the parathyroid glands . Am J Pathol 61:233-248, 1970;.
14 +
Jakobiec FA, Font R, Johnson F:  Angiomatosis retinae: An electron microscopic study with lipid analysis . Cancer 38:2042-2056, 1976;.
15 +
Nicholson D, Green W, Kenyon K:  Light and electron microscopic study of early lesions in angiomatosis retinae . Am J Ophthalmol 82:193-204, 1976;.
16 +
Jakobiec FA, Font R, Iwamoto T: Diagnostic ultrastructural pathology of ophthalmic tumors, in Jakobiec FA (ed): Ocular and Adnexal Tumors. Birmingham, Ala, Aesculapius, to be published.
17 +
Silvers D, Becker L, Hiles E:  Epidermal melanocytes in eruptive xanthomas . Arch Dermatol 107:847-852, 1973;.
18 +
Kenyon K:  Ocular ultrastructure of inherited metabolic disease , in Goldbery M (ed): Genetic and Metabolic Eye Disease . Boston, Little Brown & Co, 1974;, pp 139-186.
19 +
Cogan DG, Kuwabara T:  The sphingolipidoses and the eye . Arch Ophthalmol 79:437-452, 1968;.
20 +
Kenyon KR, Sensenbrenner JA:  Mucolipidosis II (I—cell disease): Ultrastructural observations of conjunctiva and skin . Invest Ophthalmol 10:555-567, 1971;.
21 +
Brownstein S, Meagher-Villemure K, Polomeno RC, et al:  Optic nerve in globoid leukodystrophy (Krabbe's disease): Ultrastructural changes . Arch Ophthalmol 96:864-870, 1978;.
22 +
Shields JA, Annesley W, Totino J:  Nonfluorescent malignant melanoma of the choroid diagnosed with the radioactive phosphorus uptake test . Am J Ophthalmol 79:634-640, 1975;.
23 +
Jakobiec FA, Chattock A:  The role of cytology and needle biopsies in the diagnosis of ophthalmic tumors and simulating conditions , in Jakobiec FA (ed): Ocular and Adnexal Tumors . Birmingham, Ala, Aesculapius, 1978;, pp 341-358.

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