Partial Nephrectomy as Management of Oligometastatic Cancer with Limited Systemic Treatment Options: A Case Report

Area of Science:

• Ophthalmology
• Oncology
• Surgical Oncology

Background:

• Ocular melanoma presents challenges due to limited actionable mutations for systemic therapy and radioresistance.
• Surgery is the primary treatment for localized ocular melanoma and can be considered for oligometastatic disease.

Purpose of the Study:

• To present a case of ocular melanoma with a late solitary renal metastasis.
• To discuss the surgical management of solitary metastases in ocular melanoma.
• To emphasize the importance of interdisciplinary management in metastatic melanoma.

Main Methods:

• Case report of a patient with ocular melanoma initially treated with intraocular brachytherapy.
• Surgical management including partial nephrectomy for a solitary renal metastasis.
• Surgical management for a subsequent solitary breast metastasis before systemic therapy initiation.

Main Results:

• A solitary renal metastasis occurred 9 years after initial ocular melanoma treatment.
• The patient remained disease-free for 3.5 years post-nephrectomy.
• A subsequent solitary breast metastasis was surgically managed before systemic therapy.

Conclusions:

• Solitary metastases in ocular melanoma can occur years after initial treatment.
• Surgical intervention for solitary metastases is a viable option in select cases.
• Interdisciplinary management is crucial for patients with metastatic ocular melanoma, considering the evolving treatment landscape.