Metastatic uveal melanoma. Pretherapy serum liver enzyme and liver scan abnormalities

The liver was the organ most frequently involved in 50 patients with primary melanomas of the choroid or ciliary body, who were treated with enucleation or cobalt plaque radiotherapy and who subsequently developed systemic metastasis. Forty-seven (94%) of the patients had clinical or laboratory evidence of liver metastasis. The median survival time following treatment of the primary choroidal melanoma was 28 months (range, 7.7 to 123.1 months). Results of pretreatment studies, including serum liver enzyme levels, liver scans, or both, were abnormal in six (12%) of the patients studied. As a group, the eight patients who died within one year following ocular surgery had a significantly higher prevalence of pretreatment laboratory abnormalities. Extraocular extension of the choroidal melanoma was also present in four (50%) of these eight patients. Conversely, no patient who survived longer than the median survival period (28 months) had abnormal pretreatment laboratory findings.