Cutaneous Malignant Melanoma With Diffuse Intraocular Metastases

Bowman, C. Bradley; Guber, D; Brown, Cheryl; Curtin, Victor T.

doi:10.1001/archopht.1994.01090210097022

Cited by 29 publications

(22 citation statements)

References 4 publications

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“…9 Intractable pain due to rubeotic glaucoma in a blind eye is considered to be an indication for enucleation. 4,8,23 In the case we report tumour regression failed to occur with external beam radiation; similarly others found combined external beam radiation and intravenous vindesine failed to induce tumour regression. 8 Various chemotherapeutic agents have been used.…”

Section: Commentsupporting

confidence: 65%

Intraocular metastases of cutaneous malignant melanoma: A case report and review of the literature

Ramaesh

Marshall

Wharton

et al. 1999

Eye

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Section: Commentsupporting

confidence: 65%

Intraocular metastases of cutaneous malignant melanoma: A case report and review of the literature

Ramaesh

Marshall

Wharton

et al. 1999

Eye

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“…Tumour invasion of the vitreous body has been described clinically as being composed of either isolated cells forming irregular aggregates [5, 7, 16, 17,19,20,21, 23] or spherical tumour masses suspended in the vitreous [4, 24, 36], like those observed in the case reported here. The density of vitreous opacities, possibly associated with vitreous haemorrhage, can sometimes interfere with or prevent ocular fundus examination [5, 11, 17, 21] and require exploratory vitrectomy.…”

Section: Discussionsupporting

confidence: 52%

“…In various published series, this metastatic site was observed in 10–23% of cases of melanomas with intra-ocular metastases [5,6,7]. Cases of melanomas with metastases involving exclusively the retina [4, 6,8,9,10,11], the retina and posterior uvea with or without papillary involvement [12,13,14], the retina and anterior uvea [15], exclusively the vitreous [4, 5,16,17,18], the retina and vitreous [5, 11,19,20,21,22], the vitreous and anterior uvea [18, 23] and the optic disk and vitreous [24] have been described on several occasions. These metastases were secondary to a cutaneous melanoma in all but two cases, in which the metastases were derived from a conjunctival melanoma in the contralateral eye in one case [14] and from an unknown primary in the other case [7].…”

Section: Discussionmentioning

confidence: 99%

“…Floaters [4, 5, 11, 19, 21, 24, 36], varying degrees of visual disorders or impaired visual acuity [11, 13, 16, 17, 20, 21, 23, 24, 36] or inflammatory phenomena, with or without associated ocular pain [7, 14, 18, 20], were the usual presenting symptoms leading to the discovery of retinal and vitreous metastases of melanoma. However, in some cases [9, 10], as in the case reported here, metastases have been demonstrated during assessment of asymptomatic patients, looking for a primary or secondary intra-ocular melanoma in patients with multiple metastases.…”

Section: Discussionmentioning

confidence: 99%

“…In the published cases, patients with retinal and vitreous metastases from melanoma also presented known metastases in other sites [4,5,6,8,9,10,11, 13, 14, 16,18,19,20,21,22,23,24, 37] or metastases that were diagnosed soon after demonstration of the intra-ocular metastases [17, 36]. Retinal and vitreous metastases of melanomas were associated with central nervous system metastases on several occasions [5, 6,9,10,11,12, 14,20,21,22, 36].…”

Section: Discussionmentioning

confidence: 99%

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Systemic Melanoma Metastatic to the Retina and Vitreous

et al. 2004

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Purpose: Report of a case of retinal and vitreous metastases of a systemic melanoma, possibly arising in the lung, that responded favourably to radiotherapy. Case Report: Retinal and vitreous metastases were demonstrated in a 57-year-old woman during routine follow-up after surgical resection of a melanoma presumed to be a primary pulmonary melanoma. After a 7-week observation period, which confirmed the progressive nature of the intra-ocular lesions, the patient was treated by external beam radiotherapy at a dose of 35 Gy delivered in 14 fractions of 2.5 Gy. Complete disappearance of the vitreous invasion and progressive elimination of the retinal invasion were observed over a period of 9 months. Final visual function was 20/25. Review of Published Cases: A review of the literature identified 28 cases of melanoma with metastases to the retina and vitreous. In almost all of these cases, the primary tumour was a cutaneous melanoma and the mean patient survival following the diagnosis of intra-ocular metastases was 22 months. Retinal metastases, as in the case reported here, present a vascular tropism and tend to develop around veins. These metastases are generally unilateral and may be either solitary or multiple. Tumour invasion of the vitreous occurred by means of isolated cells forming a suspension of aggregates or spherules. Vitreous haemorrhage and irreducible neovascular glaucoma leading to functional impairment, which requires enucleation, were both the most frequent and the most serious complications of these metastases. Treatment is always palliative and is effective in cases with limited retinal and vitreous invasion, as in the case reported here. Conclusions: Metastatic melanoma in the retina and vitreous is a rare entity and can lead to functional impairment and enucleation because of neovascular glaucoma. As treatment is only effective in cases with limited invasion, systematic screening is recommended in all patients with a metastatic cutaneous melanoma presenting with suggestive ocular symptoms.

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Cutaneous Melanoma Metastatic to Anterior Lens Capsule

2018

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A 71-year-old man with psoriatic arthritis and stage IV cutaneous melanoma presented with iritis in the right eye. Treatment included topical corticosteroids; however, low-grade cellularity persisted, and iritis developed in the left eye. He was receiving pembrolizumab, a systemic checkpoint inhibitor. Checkpoint inhibitors are increasingly used to treat cutaneous melanoma, and these medications can cause uveitis. 1 The patient's chronic bilateral iritis led to posterior subcapsular cataracts, which decreased visual acuity to 20/80 OD and 20/50 OS. Multiple pigmented deposits were visualized on the right anterior lens capsule and iris (Figure , A). A capsulorhexis specimen obtained during cataract surgery revealed melanoma deposits (Figure , B) and established the true cause of pseudouveitis, namely, intraocular metastases from cutaneous melanoma. Cutaneous melanoma rarely metastasizes to the eye. [2][3][4] Visual acuity improved to 20/25 OD after surgery. Abdominal metastases led to death 7 months later.

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Cutaneous Malignant Melanoma With Diffuse Intraocular Metastases

Cited by 29 publications

References 4 publications

Intraocular metastases of cutaneous malignant melanoma: A case report and review of the literature

Intraocular metastases of cutaneous malignant melanoma: A case report and review of the literature

Systemic Melanoma Metastatic to the Retina and Vitreous

Cutaneous Melanoma Metastatic to Anterior Lens Capsule

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