Metastatic tumor to the retina and vitreous cavity from primary melanoma of the skin: treatment with systemic and subconjunctival chemotherapy.

The cases of two young women with metastatic tumors to the retinas and vitreous cavities from primary melanoma of the skin are discussed. Each presented with 20/20 central visual acuity in both eyes and complaints of floaters related to singularly unusual golden brown cellular aggregates infiltrating the vitreous cavities. Some cells appeared to be emanating from the region of the optic nerves whereas others appeared to originate from the superficial retina, presumably from the retinal vessels. The cellular aggregates were comprised of malignant melanoma cells as determined by histocytology of a vitrectomy specimen in one case and an aqueous aspirate in the other. The clinical appearance of cellular aggregates in the form of regular spherules should alert the clinician to the possibility of malignant rather than inflammatory cellular infiltration. The combined administration of repeated systemic and subconjunctival DTIC in case 1 and BCNU in case 2 was unsuccessful in promoting tumor regression. Histology of one eye, removed because of uncontrolled neovascular glaucoma, revealed numerous melanoma cells in the superficial retina and adjacent vitreous.