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Metastasis from untreated uveal melanomas.
Archives of Ophthalmology (Chicago, Ill. : 1960)
|November 1, 1986
Summary
Metastatic melanoma from choroidal or ciliary body tumors is rare, occurring in 2.2% of cases. Pretreatment medical evaluation, liver enzyme studies, and chest X-rays are recommended for early detection.
Area of Science:
- Ophthalmology
- Oncology
- Medical Imaging
Background:
- Choroidal and ciliary body malignant melanomas are rare ocular tumors.
- Metastasis is a significant concern for patient prognosis.
Purpose of the Study:
- To evaluate the incidence of metastasis in patients with choroidal or ciliary body melanoma.
- To assess the utility of pretreatment diagnostic evaluations for detecting metastatic disease.
Main Methods:
- Retrospective review of 224 cases of choroidal or ciliary body malignant melanoma.
- Analysis of metastatic evaluations performed prior to enucleation or radiation treatment.
- Histological verification of metastatic melanoma.
Main Results:
- Five cases (2.2%) demonstrated evidence of metastasis during pretreatment evaluation.
- Metastatic melanoma was histologically confirmed in all positive cases.
- Normal liver enzyme levels correlated with a low yield for detecting liver metastasis via CT scan.
Conclusions:
- A general medical evaluation, liver enzyme studies, and chest roentgenogram are recommended prior to treatment for ocular melanoma.
- Computed tomography (CT) of the liver is indicated if liver involvement is suspected based on clinical or laboratory findings.
- Routine CT of the liver for initial surveillance may not be cost-effective in the absence of abnormal liver enzyme levels.