Extraocular Seeding of Choroidal Melanoma After a Transretinal Biopsy With a 25-Gauge Vitrector

Abstract

The seeding of melanoma corresponded to the sites of sclerotomy, indicating extraocular seeding of the primary tumor after transretinal biopsy. We discuss the possible reasons for this occurrence and strategies to prevent extraocular seeding of melanoma after transretinal biopsy.

Effects of plaque brachytherapy and proton beam radiotherapy on prognostic testing: a comparison of uveal melanoma genotyped by microsatellite analysis

“…31 There have also been other case reports and series of suspected dissemination, which has contributed to the reluctance of some ophthalmologists to take diagnostic and prognostic biopsies. [32][33][34][35] In this study, Cox analysis shows no evidence that a biopsy taken before or after radiotherapy affects the metastatic event hazard rate. This is consistent with the findings of a recent study by Bagger et al where a retrospective nationwide audit of 1637 UM patients demonstrated that melanoma-specific mortality was not increased in biopsied patients as compared with non-biopsied patients.…”

Intraocular biopsy of uveal melanoma Risk assessment and identification of genetic prognostic markers

“…However, risk of scleral seeding is not entirely eliminated, demonstrated by a case report of extra ocular recurrence at the scleral port entry site following a transvitreal biopsy (Raja et al. ).…”

Outcomes of 27-Gauge Vitrectomy-Assisted Choroidal and Subretinal Biopsy

“…[3][4][5][6] Although performed under direct visualization, it is challenging to assess the vitreous cutter probe depth within the choroidal tumor and chorioretinal biopsy does confer a greater risk of iatrogenic morbidity including subretinal hemorrhage, vitreous hemorrhage, retinal detachment and the possibility of extrascleral extension. 4,[7][8][9][10][11][12][13][14] First described in 2010 by Oshima et al, and recently introduced commercially, the 27-gauge microincision vitrectomy system offers advantages compared to larger gauges in terms of smaller scleral wounds, decreased postoperative pain and inflammation, and faster visual recovery. 15 Although the efficacy of transvitreal retinochoroidal biopsy with a 25-gauge vitrector system has been demonstrated, no series regarding outcomes of 27-gauge vitrectomy assisted transvitreal choroidal or subretinal biopsy have been published since the commercial introduction of this technology by several different manufacturers.…”