[Post-radiation choroidal melanoma pathomorphosis assessment in clinical practice]

Area of Science:

• Ophthalmology
• Oncology
• Pathology

Context:

• Choroidal melanoma (CM) is a rare intraocular malignancy.
• Organ-preserving treatments aim to save the eye while managing CM.
• Secondary enucleation is sometimes necessary after initial treatment.

Purpose:

• To investigate the pathomorphological changes in eyes requiring secondary enucleation post-CM treatment.
• To assess the effectiveness of various organ-preserving therapies (brachytherapy, proton therapy, Gamma Knife) by examining enucleated eyes.

Summary:

• This study analyzed 22 enucleated eyes with CM treated with organ-preserving methods.
• Common findings included scleral invasion, Bruch's membrane rupture, and lymphocytic infiltration.
• Therapeutic effects showed significant TRG4 and TRG3 grades, with low vascular invasion but persistent viable tumor cells and mitotic activity (average 1.6±1.5/mm²).

Impact:

• Findings highlight that residual viable tumor cells and mitotic activity post-treatment signify incomplete tumor control.
• This underscores a significant risk for tumor recurrence and metastasis, irrespective of the organ-preserving strategy used.
• The study informs prognostic assessments and treatment strategies for choroidal melanoma.