{
  "abstract": "Purpose: To report a case of medulloepithelioma treated with palladium-103 ( 103 Pd) plaque brachytherapy, followed by adjunctive continuous periodic intravitreal anti–vascular endothelial growth factor (anti-VEGF) therapy, highlighting a novel combined strategy for tumor control and management of its neovascular complications. Observations: A 9-year-old male presented with a ciliary body mass causing anterior displacement of the iris and iris neovascularization in the right eye. Initial tumor dimensions were 8 × 8 mm in basal diameters and 3.9 mm in thickness. Aspiration cutter–assisted biopsy was used to confirm the diagnosis of medulloepithelioma. Treatment involved temporary placement of a 14-mm 103 Pd plaque, which irradiated the tumor's apex to 101.4 Gy (Gy) over 7 days. Despite tumor control, progressive iris neovascularization with secondary angle-closure glaucoma was managed by continuous periodic intravitreal anti-VEGF pharmacotherapy and two peripheral iridotomies. At 18 months post-plaque brachytherapy, a posterior subcapsular cataract developed that required extraction with intraocular lens placement. At 5 years post-plaque brachytherapy, a macular epiretinal membrane developed that was pealed during pars plana vitrectomy surgery. At 6 years 2 months follow-up post-plaque brachytherapy the tumor's thickness had decreased from 3.9 to 2.1 mm (46.2%) and the visual acuity had declined from 20/20 to 20/63. No metastases were detected. Conclusions and importance: 103 Pd plaque brachytherapy was used to control a ciliary body medulloepithelioma. However, iridotomies and continuous periodic anti-VEGF therapy were needed to suppress tumor-related secondary neovascular glaucoma. This approach achieved durable local tumor control while preserving the globe and functional vision. Targeted radiation and pharmacologic neovascular suppression offered a novel globe and vision-sparing treatment for medulloepithelioma.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Ocular Tumor, Orbital Disease, and Ophthalmic Radiation Therapy, The New York Eye Cancer Center, 115 East 61st Street, New York City, NY, 10065, USA",
    "Department of Ophthalmology, Tulane University School of Medicine, 131 S. Robertson St, 12th Floor, Mail Code 8069, New Orleans, LA, 70112-2632, USA; Corresponding author. The New York Eye Cancer Center, 115 East 61st Street, Suite 5A/B, New York, NY, 10065, USA."
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 2,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Skylar L. Wingate"
    },
    {
      "affs": [
        1
      ],
      "name": "Paul T. Finger"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7gbhnj3cedmk5.bib",
  "cited_by": 0,
  "doi": "10.1016/j.ajoc.2026.102692",
  "fulltext_url": "http://www.sciencedirect.com/science/article/pii/S2451993626001805",
  "id": "7gbhnj3cedmk5",
  "issns": [
    "2451-9936"
  ],
  "landing_url": "https://doi.org/10.1016/j.ajoc.2026.102692",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "RE1-994"
    ],
    [
      "openalex",
      "2731|Ocular Oncology and Treatments"
    ]
  ],
  "openalex": "W7223444802",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-31",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/7gbhnj3cedmk5.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T14:21:48Z",
      "native_id": "060491df1867491db86ed577a7a24936",
      "source": "doaj",
      "url": "https://doi.org/10.1016/j.ajoc.2026.102692"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2731|Ocular Oncology and Treatments",
      "subfield": "general"
    }
  ],
  "title": "Palladium-103 brachytherapy with continuous periodic intravitreal Anti-VEGF bevacizumab for ciliary body medulloepithelioma",
  "title_text": "Palladium-103 brachytherapy with continuous periodic intravitreal Anti-VEGF bevacizumab for ciliary body medulloepithelioma",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T14:21:48Z",
  "url": "https://research.draconitic.com/paper/7gbhnj3cedmk5",
  "venue": "American Journal of Ophthalmology Case Reports",
  "versions": []
}