[The malignancy of choroidal melanomas (author's transl)]

In the destruction of choroidal melanomas with conservation of the globe two clinical parameters, the size and growth-rate of the tumor, are especially important. The malignancy can be determined from these two parameters. It is important to know that neoplasms metastasize when they are composed of more than 400 cells (10 doubling times). However, at this early stage clinical diagnosis it rarely possible. As a rule, the tumor cannot be diagnosed until it reaches a size of 5 mm (27 doubling times). Metastases must be at least 10 mm in diameter (38 doubling times) to be recognized. In the case of the fast-growing choroidal melanomas it can therefore be calculated that the formation of metastases reaches a peak after a period of three to four years, assuming that diagnosis is made as early as possible. In 64 patients followed up for five years we found that the more numerous the number of mitoses in the tissue are, the higher the mortality is and the sooner the patients die. According to our results the most important clinical parameter in the assessment of choroidal melanoma, apart from the size of the tumor, is the estimation growth-rate, as indicated by the number of mitoses.