Retinoinvasive Uveal Melanoma: Report of 2 Cases and Review of the Literature

Abstract

Purpose: To describe the clinical history and histopathologic findings of 2 cases of retinoinvasive uveal melanoma. Methods: The medical records and pathology specimens of 2 patients with retinoinvasive uveal melanoma were reviewed. Results: The first patient had an iris/ciliary body melanoma that was treated and the second patient had suspected iridocorneal endothelial syndrome. Both patients developed a blind, painful eye; the first patient's right eye was enucleated and the left eye of the second patient underwent evisceration. Histopathologic examination of the enucleated eye showed a tumor composed of minimally pigmented spindle-shaped cells with fusiform nuclei and prominent nucleoli and round cells with prominent nucleoli. The tumor cells invaded into the retina where they formed perivascular aggregates. Examination of the evisceration specimen showed a proliferation of pigmented tumor cells within the stroma of one iris leaflet. The tumor cells extended onto the ciliary body and vitreous base and invaded the retina. The pathologic diagnosis in both patients was retinoinvasive uveal melanoma. Conclusions: Careful funduscopic and imaging examination should be performed in eyes with unilateral glaucoma with iris/ciliary body lesions, and enucleation, rather than evisceration, should be performed, as retinoinvasive melanoma is in the differential diagnosis.

Vitreous and Preretinal Seeding After Transvitreal Fine Needle Aspiration Biopsy of Choroidal Melanoma

“…Several groups have reported the rare occurrence of retinal and optic nerve invasion by uveal melanoma remote from the site of the uveal tumor, a condition referred to as retinoinvasive uveal melanoma. 17–19 The current case shares several features with retinoinvasive uveal melanoma, namely vitreous seeding, invasion of neurosensory retina away from the main uveal tumor, and optic nerve invasion. We hypothesize that the tumor in the current case probably belonged to this particular subtype of uveal melanoma (retinoinvasive), and the transvitreal FNAB allowed implantation of the invasive melanoma cells into the vitreous cavity.…”

Multifocal Intraretinal Tumour Deposits following Treatment of an Ipsilateral Choroidal Melanoma

“…Finally, these lesions may suggest the presence of a retinoinvasive melanoma. This is a rare subtype of uveal melanoma, which was described by Kivelä and Summanen [14] in 1997, and has been further reported in a small number of limited case series [15, 16]. It is characterised by transvitreal melanoma invasion of the retina at a site non-contiguous with the uveal tumour.…”