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Ocular Melanomas: Uveal Melanoma
Uveal (choroidal) melanomas are the most common primary
malignant intraocular tumor in adults with an annual incidence of
6 cases per million per year. They can affect the iris, the ciliary
body or (most commonly) the choroid (a vascular layer deep to the
retina).
Symptoms and signs:
Choroidal melanomas may be completely asymptomatic at the time
of diagnosis or may be associated with visual loss or flashes and
floaters.
Diagnosis:
The diagnosis of uveal melanoma is made with clinical examination
using an indirect ophthalmoscope and judicious use of ancillary
studies such as fluorescein angiography and ultrasonography.
Treatment Options:
Enucleation (removal of the eye leaving the ocular adnexal structures
including the extraocular muscles intact) is an option, particularly
for larger tumors. Radioactive plaques are also an alternative for
small to medium sized tumors. The use of some forms of laser or
proton beam therapy may also be indicated in some cases.
Long-term prognosis:
It is recommended that patients with uveal melanomas, regardless
of their local treatment modality, be monitored frequently to look
for evidence of local recurrence or distant metastasis. It is estimated
that 20-50% of patients develop distant metastasis (usually to the
liver) in their lifetime.
Research endeavors:
M.D. Anderson is conducting studies dealing with serologic tumor markers
for detection of early metastasis in uveal melanomas and genetic
and molecular characteristics of individual tumors that may predict
outcome.
The Melanoma Medical Oncology Department at M.D. Anderson is
currently recruiting patients with metastatic choroidal melanomas
to participate in several clinical trials available within that
department.
For more information or to schedule an appointment, please call
(713) 794-1247 or the new patient referral line: 1 (800)392-1611.
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