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Extraocular seeding of choroidal melanoma after a transretinal biopsy with a 25-gauge vitrector
Vignesh Raja1, Andrea Russo, Sarah Coupland
1From the *Liverpool Ocular Oncology Centre, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom; and †Department of Pathology, School of Cancer Studies, University of Liverpool, Liverpool, United Kingdom.
Purpose:
To report an isolated case of extraocular seeding of choroidal melanoma after a transretinal biopsy.
Methods:
A 74-year-old man with a choroidal melanoma in the left eye underwent a 3-port transconjunctival 25-gauge transretinal biopsy (for cytogenetic prognostication) followed by proton beam radiotherapy. Biopsy showed the melanoma to be predominantly of spindle cell type with chromosome 3 loss. He presented 14 months later with two pigmented conjunctival lesions, corresponding to the site of the pars plana sclerotomy.
Results:
Excision biopsy of the conjunctival lesions confirmed subconjunctival seeding of melanoma cells at the sites of sclerotomy.
Conclusion:
The seeding of melanoma corresponded to the sites of sclerotomy, indicating extraocular seeding of the primary tumor after transretinal biopsy. We discuss the possible reasons for this occurrence and strategies to prevent extraocular seeding of melanoma after transretinal biopsy.
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