Iwona Rospond-Kubiak1, Carl Groenewald2, Sarah E Coupland3, Bertil Damato4. 1. Liverpool Ocular Oncology Centre, Royal Liverpool University Hospital, Liverpool, UK; Department of Ophthalmology, Poznań University of Medical Sciences, Poznań, Poland. 2. Liverpool Ocular Oncology Centre, Royal Liverpool University Hospital, Liverpool, UK. 3. Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK. 4. Ocular Oncology Service, Department of Ophthalmology, San Francisco, Calif., USA; Department of Radiation Oncology, University of California, San Francisco, San Francisco, Calif., USA.
Abstract
AIM: To present a case of neoadjuvant treatment of uveal melanoma with a limited core endoresection, which enabled ruthenium plaque radiotherapy to be administered. MATERIAL AND METHODS: A 77-year-old woman presented in 2005 with a ciliochoroidal uveal melanoma measuring 7.2 by 6.5 mm basally with a thickness of 6.2 mm. The vision in the affected eye was 6/9. Because of diagnostic uncertainty, we performed a biopsy, which produced a copious sample. The biopsy serendipitously reduced the tumour thickness to 4.4 mm, making ruthenium plaque brachytherapy possible. RESULTS: Histopathological examination showed the tumour to be a melanoma predominantly of spindle cell type. Postoperative complications included a dense vitreous haemorrhage, which cleared spontaneously, and raised intraocular pressure, controlled with latanoprost. Seven years after brachytherapy, the vision was 6/5 and the thickness of the residual tumour was 2.5 mm. Nine years after treatment, there was no evidence of any intra- or extraocular seeding or distant metastases. CONCLUSIONS: Core endoresection of a ciliochoroidal melanoma may reduce tumour thickness enough to allow subsequent ruthenium plaque radiotherapy.
AIM: To present a case of neoadjuvant treatment of uveal melanoma with a limited core endoresection, which enabled ruthenium plaque radiotherapy to be administered. MATERIAL AND METHODS: A 77-year-old woman presented in 2005 with a ciliochoroidal uveal melanoma measuring 7.2 by 6.5 mm basally with a thickness of 6.2 mm. The vision in the affected eye was 6/9. Because of diagnostic uncertainty, we performed a biopsy, which produced a copious sample. The biopsy serendipitously reduced the tumour thickness to 4.4 mm, making ruthenium plaque brachytherapy possible. RESULTS: Histopathological examination showed the tumour to be a melanoma predominantly of spindle cell type. Postoperative complications included a dense vitreous haemorrhage, which cleared spontaneously, and raised intraocular pressure, controlled with latanoprost. Seven years after brachytherapy, the vision was 6/5 and the thickness of the residual tumour was 2.5 mm. Nine years after treatment, there was no evidence of any intra- or extraocular seeding or distant metastases. CONCLUSIONS: Core endoresection of a ciliochoroidal melanoma may reduce tumour thickness enough to allow subsequent ruthenium plaque radiotherapy.
Authors: L Lumbroso-Le Rouic; M Charif Chefchaouni; C Levy; C Plancher; R Dendale; B Asselain; S Solignac; A Mazal; L Desjardins Journal: Eye (Lond) Date: 2004-09 Impact factor: 3.775