Metastatic melanoma in the eye and orbit

Zografos, Léonidas; Ducrey, N; Beati, D.; Schalenbourg, Ann; Spahn, B.; Balmer, Aubin; Othenin-Girard, Chantal Bornet; Chamot, Line; Egger, Emmanuel

doi:10.1016/j.ophtha.2003.05.004

Cited by 99 publications

(78 citation statements)

References 38 publications

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“…Although melanomas with less than 0.76 mm of thickness are considered to have a 5-year survival rate of 96 to 99%, the reported case developed systemic metastases 6 years after excision. Prognosis when ocular metastases are present is poor with a survival rate less than 8 months in 90% of patients [6].…”

Section: Discussionmentioning

confidence: 99%

Bilateral choroidal metastases as presentation of dissemination of cutaneous malignant melanoma

Fernandez-Perez

Satué

García‐Martín

et al. 2012

Acta Ophthalmologica

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Case Report. A 47-year-old man presented with blurred vision in the right eye. Ophthalmoscopic examination showed several placoid, pigmented lesions in the posterior pole and midperiphery of the retina of both eyes. Results. Patient referred a cutaneous malignant melanoma on the back skin removed 6 years ago. A systemic workup revealed multiple metastases in liver and spleen. After an exhaustive study we concluded that it was a dissemination of a cutaneous malignant melanoma with bilateral choroidal metastases, liver and spleen metastases. The patient obtained clinical ocular improvement after palliative chemotherapy, although he died in the following months. Pathological examination of the lesions confirmed the diagnosis of choroidal metastases from a malignant cutaneous melanoma. Conclusions. Monitoring patients who have had cutaneous malignant melanoma is very important, since melanoma metastases may occur even many years after the diagnosis of the primary tumor. Choroidal metastases from cutaneous melanoma are uncommon but we should be aware because their appearance worsens prognosis.

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Section: Discussionmentioning

confidence: 99%

Bilateral choroidal metastases as presentation of dissemination of cutaneous malignant melanoma

Fernandez-Perez

Satué

García‐Martín

et al. 2012

Acta Ophthalmologica

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“…Intraocular metastases of melanoma are associated with a poor prognosis with a mean interval between diagnosis of the intraocular metastasis and death of 8.8 months [17]. In contrast, survival in patients diagnosed with a primary intraocular melanoma is more variable, with a reported 5-year cumulative survival rate of up to 60% [12].…”

Section: Discussionmentioning

confidence: 99%

“…The commonest primary intraocular malignancy of adults is uveal melanoma [10]. Metastatic melanoma to the eye is rare and generally occurs in patients with widespread metastatic disease [17]. The most common site of metastatic cutaneous melanoma involvement of the eye is the choroid (46%).…”

Section: Introductionmentioning

confidence: 99%

“…Metastatic melanoma to the vitreous and anterior chamber is rare (11-18% of all intraocular cutaneous melanoma metastases) [6]. Differentiation between a primary uveal melanoma and an intraocular metastasis is of prognostic and clinical importance, as intraocular metastases imply systemic spread and have a poor prognosis with a patient survival rarely exceeding more than 1 year [17].…”

Section: Introductionmentioning

confidence: 99%

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Occurrence of ocular melanoma thirteen years after skin melanoma: two separate primaries or metastatic disease? A case solved with NRAS and CDKN2A (INK4A-ARF) mutational analysis

et al. 2008

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The differential diagnosis between primary uveal melanoma and cutaneous melanoma metastasis in the eye may be difficult, both clinically and histologically. We report successful application of combined mutational analysis of the NRAS and the CDKN2A gene to discriminate between these two entities. The patient had a history of a superficial spreading cutaneous melanoma of the left shoulder. Nine years later, she developed a lymph node metastasis in the left axilla, and 13 years later she presented with an atypical, pigmented tumor in the uvea. Histologically, the origin of the uveal melanoma could not be determined with certainty. We performed molecular analysis on the skin melanoma, the lymph node metastasis and the uveal melanoma. We detected an NRAS codon 61 mutation (c.182A>G, p.Gln61Arg) in all three tumor specimens. This mutation was absent in the normal control tissue of the patient, thereby excluding a germline mutation. To confirm a clonal relationship between the tumors, we also performed CDKN2A mutational analysis. We detected a CDKN2A mutation ((p16) c.238C>T, p.Arg80X, (p14) c.404C>T, p.Pro135Leu)) in the tumor samples, but not in the normal control tissue of the patient. We concluded that the uveal melanoma is a metastasis from the cutaneous melanoma removed 13 years before.

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“…The most common types of cancer that metastasize to the eye are carcinomas, however, sarcomas and melanomas may also metastasize to the eye (12,13). The prevalence of uveal metastasis from all forms of carcinomas varies from 2.3 to 9.2% in the published series with breast cancer being the most common primary site followed by lung cancer (2,5,9).…”

Section: Introductionmentioning

confidence: 99%

Uveal metastatic disease: Current and new treatment options (Review)

Giuliari¹,

Sadaka²

2011

Oncol Rep

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Abstract. Choroidal metastasis represents the most common form of intraocular malignancies. It may occur in up to 10% of patients with systemic metastasis with almost half of the patients developing central nervous system disease. The most common primary sites of ocular metastasis are breast cancer in women and lung cancer in men. In most cases, these lesions tend to be asymptomatic and are not evaluated by an ophthalmologist. The diagnosis is generally made by the history of present or prior malignancies and an ophthalmological examination with slit-lamp biomicroscopy and indirect ophthalmoscopy. As with other malignancies, management may vary with each patient. Small tumors, that do not compromise the vision and that have responded previously to systemic treatment, may be closely observed. For larger lesions and for symptomatic ones, external beam radiation offers an excellent alternative to save the eye and stabilize vision. Bevacizumab (Avastin), a potent monoclonal antibody that has also been employed for the treatment of ocular vaso-proliferative diseases, has been used in the treatment of choroidal metastasis and has shown promising results.

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Metastatic melanoma in the eye and orbit

Cited by 99 publications

References 38 publications

Bilateral choroidal metastases as presentation of dissemination of cutaneous malignant melanoma

Bilateral choroidal metastases as presentation of dissemination of cutaneous malignant melanoma

Occurrence of ocular melanoma thirteen years after skin melanoma: two separate primaries or metastatic disease? A case solved with NRAS and CDKN2A (INK4A-ARF) mutational analysis

Uveal metastatic disease: Current and new treatment options (Review)

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