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Updated: Jun 16, 2026
Implantation and Evaluation of Melanoma in the Murine Choroid via Optical Coherence Tomography
Published on: December 2, 2022
Choroidal melanoma in a 7-year-old child treated by trans-scleral local resection
Andrea Russo1, Sarah Ellen Coupland, Michael O'Keefe
1St Paul's Eye Unit, Oncology Service, Royal Liverpool University Hospital, Liverpool, UK.
Insights
This study details the successful trans-scleral resection and brachytherapy for a pediatric choroidal melanoma, preserving the eye and vision. Genetic analysis indicated a favorable prognosis for the young patient.
Area of Science:
- Ophthalmology
- Pediatric Oncology
- Genetics
Background:
- Choroidal melanoma is rare in children.
- Family history of neurofibromatosis type I (NF1) and melanoma present.
- Differential diagnosis included neurilemmoma, leiomyoma, and neurofibroma.
Observation:
- A 7-year-old child presented with a choroidal tumor.
- Treatment involved trans-scleral local resection followed by adjuvant brachytherapy.
- Histopathology confirmed amelanotic melanoma, spindle cell type, with 7 mitoses/40 HPF.
Findings:
- Multiplex ligation-dependent probe amplification (MLPA) revealed favorable genetic markers (2 copies of chromosome 3, 3 copies of 6p, 2 copies of 8).
- Postoperative evaluation at 6 months showed no residual tumor and a flat retina.
- Visual acuity was 6/60, indicating good vision retention.
Implications:
- Trans-scleral resection and brachytherapy are viable treatment options for pediatric choroidal melanoma.
- Favorable cytogenetic findings can reassure families regarding prognosis.
- Early detection and multimodal treatment can lead to successful outcomes in pediatric ocular tumors.
Purpose:
To report a choroidal melanoma in a 7-year-old child treated by trans-scleral local resection and adjuvant brachytherapy with a family history of neurofibromatosis type I (NF1) and cutaneous melanoma.
Patient And Methods:
A 7-year-old child was referred for treatment of a choroidal tumor in her left eye with a differential diagnosis of melanoma, neurilemmoma, leiomyoma, and neurofibroma. Trans-scleral local resection and, subsequently, adjuvant brachytherapy were performed.
Results:
Histopathology and immunohistochemistry of the specimen diagnosed an amelanotic melanoma of spindle cell type, with a moderately high number of mitoses (7/40 HPF). Multiplex ligation-dependent probe amplification (MLPA) analysis showed two copies of chromosome 3, three copies of the short arm of chromosome 6, and two copies of chromosome 8, strongly suggesting a good prognosis. Postoperative ophthalmic evaluation at 6 months showed no visible tumor and flat retina with visual acuity (VA) of 6/60.
Conclusions:
Trans-scleral local resection with adjuvant brachytherapy in children is possible using the same techniques as for adults. Although the follow-up is short, our patient retained the eye with good vision and our cytogenetic studies allowed us to reassure the mother.
