Grace C Shih1, Bao Han A Le1,2, Zelia M Correa3, Maria E Sibug-Saber4, Jonathan W Kim1,5, Jesse L Berry1,5. 1. University of Southern California Roski Eye Institute, Los Angeles, CA, USA. 2. John A. Burns School of Medicine at the University of Hawaii, Honolulu, HI, USA. 3. Department of Ophthalmology, University of Cincinnati College of Medicine, Cincinnati, OH, USA. 4. Department of Pathology, Keck Hospital of USC, Los Angeles, CA, USA. 5. The Vision Center at Children's Hospital of Los Angeles, Los Angeles, CA, USA.
Abstract
PURPOSE: To describe late apical relapse of a choroidal melanoma at the site of fine needle aspiration biopsy 10 years following successful treatment with 125I brachytherapy. METHODS: Retrospective case report of a 78-year-old male presenting 10 years following successful 125I brachytherapy for a choroidal melanoma with a medium-sized nodular amelanotic tumor recurrence at the site of the prior tumor biopsy. RESULTS: Fundus photography and B-scan ultrasound documented the findings at presentation at our institution. The patient was followed closely for 8 weeks while information was retrieved from the treating institution. During this short period, there was significant apical tumor growth. Additionally, there was a clear clinical change compared to the last documented photos from 5 years prior at the treating institution. Enucleation was recommended. Pathological analysis confirmed the diagnosis of recurrent choroidal melanoma at the apex of the treated lesion, at the site of prior biopsy. Systemic surveillance was negative for metastatic disease. CONCLUSION: Current literature suggests the majority of choroidal melanoma recurrences occur within 5 years following treatment. However, this case of recurrence 10 years after brachytherapy emphasizes the importance of life-long ophthalmic care for these patients. Additionally, this case demonstrates the possibility of a rare recurrence at a prior biopsy site.
PURPOSE: To describe late apical relapse of a choroidal melanoma at the site of fine needle aspiration biopsy 10 years following successful treatment with 125I brachytherapy. METHODS: Retrospective case report of a 78-year-old male presenting 10 years following successful 125I brachytherapy for a choroidal melanoma with a medium-sized nodular amelanotic tumor recurrence at the site of the prior tumor biopsy. RESULTS: Fundus photography and B-scan ultrasound documented the findings at presentation at our institution. The patient was followed closely for 8 weeks while information was retrieved from the treating institution. During this short period, there was significant apical tumor growth. Additionally, there was a clear clinical change compared to the last documented photos from 5 years prior at the treating institution. Enucleation was recommended. Pathological analysis confirmed the diagnosis of recurrent choroidal melanoma at the apex of the treated lesion, at the site of prior biopsy. Systemic surveillance was negative for metastatic disease. CONCLUSION: Current literature suggests the majority of choroidal melanoma recurrences occur within 5 years following treatment. However, this case of recurrence 10 years after brachytherapy emphasizes the importance of life-long ophthalmic care for these patients. Additionally, this case demonstrates the possibility of a rare recurrence at a prior biopsy site.
Authors: Lee M Jampol; Claudia S Moy; Timothy G Murray; Sandra M Reynolds; Daniel M Albert; Andrew P Schachat; Kenneth R Diddie; Robert E Engstrom; Paul T Finger; Kenneth R Hovland; Leonard Joffe; Karl R Olsen; Craig G Wells Journal: Ophthalmology Date: 2002-12 Impact factor: 12.079
Authors: Arun D Singh; Carlos A Medina; Nakul Singh; Mary E Aronow; Charles V Biscotti; Pierre L Triozzi Journal: Br J Ophthalmol Date: 2015-07-31 Impact factor: 4.638
Authors: Jesse L Berry; Savita V Dandapani; Marta Stevanovic; Thomas C Lee; Melvin Astrahan; A Linn Murphree; Jonathan W Kim Journal: JAMA Ophthalmol Date: 2013-11 Impact factor: 7.389
Authors: Melinda Y Chang; Mitchell Kamrava; D Jeffrey Demanes; Min Leu; Nzhde Agazaryan; James Lamb; Joel N Moral; Robert Almanzor; Tara A McCannel Journal: Ophthalmology Date: 2012-01-31 Impact factor: 12.079
Authors: Carol L Shields; Jacqueline Cater; Jerry A Shields; Aning Chao; Hatem Krema; Miguel Materin; Luther W Brady Journal: Arch Ophthalmol Date: 2002-07