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Implantation and Evaluation of Melanoma in the Murine Choroid via Optical Coherence Tomography
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Multiple simultaneous choroidal melanomas arising in the same eye: globe salvage by radiotherapy
Matthew M Zhang1, Thanos D Papakostas2, Arnold W Malcolm3,4
1Department of Ophthalmology, Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, TN, USA.
Acta Ophthalmologica
|April 16, 2016
Summary
Multiple choroidal melanomas, a rare condition, can now be treated with radiotherapy, offering a chance for eye salvage. This study shows successful outcomes with proton beam irradiation and plaque brachytherapy, avoiding enucleation.
Area of Science:
- Ophthalmology
- Oncology
Background:
- Multiple simultaneous choroidal melanomas are exceptionally rare, often leading to misdiagnosis or enucleation.
- Historically, enucleation was the primary treatment for this condition.
Observation:
- Two patients presented with simultaneous bilateral choroidal melanomas.
- One patient had amelanotic tumors with retinal detachment; the other had typical melanoma appearance.
- Fine needle aspiration biopsy with immunohistochemistry confirmed separate melanomas in both patients.
Findings:
- Sequential radioactive iodine plaque brachytherapy resulted in regression of both tumors in the first patient.
- Proton beam irradiation led to tumor regression in the second patient.
- Both radiotherapy techniques facilitated globe salvage.
Implications:
- Definitive diagnosis of multiple choroidal melanomas can be achieved with cytology and immunohistochemistry, especially for atypical presentations.
- Radiotherapy, including proton beam irradiation and plaque brachytherapy, offers a viable alternative to enucleation for preserving the eye.
- This study expands treatment options for a rare and historically challenging ophthalmic malignancy.
