Ophthalmologica
Original Paper
Management of Choroidal Malignant Melanoma at IowaKersten R.C.Department of Ophthalmology, University of Iowa City, Iowa, USA
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Article / Publication Details
Published online: March 31, 2010
Issue release date: 1984
Number of Print Pages: 12
Number of Figures: 0
Number of Tables: 0
ISSN: 0030-3755 (Print)
eISSN: 1423-0267 (Online)
For additional information: https://www.karger.com/OPH
Abstract
Approximately 50% of patients undergoing enucleation for choroidal melanoma will eventually die of metastases. The majority of tumor related deaths will occur within 5 years of enucleation, but late metastases may occur 20–30 years after enucleation. Long-term follow-up of patients refusing treatment has shown a 100% mortality. Although recent reports have attempted to link the performance of enucleation with the development of metastases, examination of available data suggests that metastases occur preoperatively, but are subclinical at the time of enucleation. The most important variable determining prognosis in these cases is the size of the tumor at the time of diagnosis and treatment. Patients who undergo enucleation before the tumor exceeds 7 × 7 × 2 mm have an extremely favorable prognosis. Patients whose maximum tumor diameter exceeds 12 mm have an extremely poor prognosis. Metastases and extrascleral extension have both been reported to occur in tumors which failed to demonstrate growth while being followed. For these reasons we recommend immediate enucleation be carried out in all patients whose tumors exceed 7 × 7 × 2 mm and in whom the diagnosis can be confirmed by indirect ophthalmoscopy, ultrasound, fluorescein angiography, and other tests. Follow-up of non-enucleation methods of treatment of choroidal melanomas is too short to draw meaningful conclusions. The consistent finding of persistence of some tumor mass and the histopathologic presence of viable tumor cells following these treatment modalities leaves us very concerned about the long-term results in these patients. Late metastases continue to occur decades following diagnosis of a choroidal melanoma, especially if it is small. The ophthalmologist must remain aware that the results of his decision concerning treatment of a melanoma may not become apparent for many years.
© 1984 S. Karger AG, Basel
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Article / Publication Details
Published online: March 31, 2010
Issue release date: 1984
Number of Print Pages: 12
Number of Figures: 0
Number of Tables: 0
ISSN: 0030-3755 (Print)
eISSN: 1423-0267 (Online)
For additional information: https://www.karger.com/OPH
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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