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A rapidly growing choroidal melanoma.

Stephen J Laquis1, John M Freeman, James C Fleming

  • 1Department of Ophthalmology, University of Tennessee Health Science Center, Memphis, Tennessee 38163, USA.

American Journal of Ophthalmology
|April 5, 2002
PubMed
Summary

This case report details a rapidly growing choroidal melanoma in a patient with ocular melanocytosis that resisted globe-sparing treatments. Close monitoring is essential for such aggressive ocular tumors.

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Area of Science:

  • Ophthalmology
  • Oncology
  • Medical Case Reports

Background:

  • Ocular melanocytosis is a risk factor for developing choroidal melanoma.
  • Choroidal melanomas can exhibit aggressive growth patterns.

Observation:

  • A 53-year-old male with ocular melanocytosis presented with decreased vision and pain, diagnosed with choroidal melanoma.
  • The initial tumor measured 2.4 mm x 6.6 mm x 6.0 mm and was treated with transpupillary thermotherapy and iodine-125 plaque brachytherapy.
  • Both treatments failed, and the tumor grew significantly, measuring 13.6 mm x 16.5 mm x 16.9 mm at enucleation.

Findings:

  • The choroidal melanoma exhibited the most rapid growth and doubling time reported to date.
  • Histopathologic analysis classified the tumor as a mixed-cell type.

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  • The rapid growth suggests potential resistance to conventional globe-sparing therapies.

    • Implications:

    • This case reinforces the link between ocular melanocytosis and choroidal melanoma.
    • Rapid tumor growth and doubling time may predict failure of transpupillary thermotherapy and iodine-125 plaque brachytherapy.
    • Increased surveillance is crucial for patients with ocular melanocytosis and choroidal melanoma, especially those with rapid tumor progression.