Suspected vitreous seeding of uveal melanoma: relevance of diagnostic vitrectomy

Abstract

The outcome of this small cohort study shows that obtaining a vitreous specimen helps to distinguish melanophages from vital tumour cells. We could not observe an increased risk of metastasis in patients who showed melanoma cell dissemination inside the eye, compared with those patients only showing melanophages. We therefore suggest to carefully re-evaluate the necessity of enucleation in every patient.

Malignant choroidal melanoma with suspected vitreous seeding - A case report

“…So far, there were four case reports of vitreous seeding in treatment-naïve choroidal melanoma and one case series of vitreous seeding either primarily or after local intervention. [34567] Totally, there were only nine reported cases of treatment-naïve choroidal melanoma with vitreous seeding. Of these cases, vitreous seeding with malignant cells was confirmed by vitreous aspiration and cytology study in five cases.…”

“…Of these cases, vitreous seeding with malignant cells was confirmed by vitreous aspiration and cytology study in five cases. [57] The other four cases underwent enucleation without cytology proof. [346]…”

“…[34567] Pathological types of treatment-naïve choroid melanoma did not have a relation to vitreous seeding.…”

“…[34567] We enucleate the melanoma eyes immediately after vitreous opacity in our case without vitreous aspiration for cytology study. All the previous treatment-naïve cases received enucleation once vitreous seeding was suspected except one case who received transretinal endoresection after adjuvant Gamma Knife radiation.…”

“…All the previous treatment-naïve cases received enucleation once vitreous seeding was suspected except one case who received transretinal endoresection after adjuvant Gamma Knife radiation. [34567] Enucleation might be necessary when vitreous seeding in treatment-naïve choroidal melanoma is suspected. [7] Melanoma cells seeding to vitreous might lead to extraocular extension through aqueous channels, resulting in a significant risk for liver metastases and an increased local recurrence rate.…”