TY - JOUR
T1 - Intraocular dissemination of uveal melanoma cells following radiotherapy
T2 - Evolving management over the past decade
AU - Paez-Escamilla, Manuel
AU - Walter, Scott D.
AU - Mohsenin, Amir
AU - Decatur, Christina L.
AU - Harocopos, George J.
AU - Dubovy, Sander
AU - Harbour, J. William
N1 - Funding Information:
Originally submitted September 17, 2018. Revision received January 9, 2019. Accepted for publication March 11, 2019. Supported by grants to JWH from the National Cancer Institute (R01 CA125970 and CA161870), Research to Prevent Blindness, a Senior Scientific Investigator Award, the Melanoma Research Alliance, a Retina Research Foundation/Kayser Global Pan-American Award, and the Alcon Research Institute. The Bascom Palmer Eye Institute also received funding from NIH Core Grant P30EY014801 and Research to Prevent Blindness Unrestricted Grant. The funding organizations had no role in the design or conduct of this research. Dr. Harbour is the inventor of intellectual property used in the study and receives royalties from its commercialization; he is also a paid consultant for Castle Biosciences, licensee of this intellectual property. Dr. Walter served on an advisory board for Castle Biosciences. The remaining authors report no relevant financial disclosures. Address correspondence to J. William Harbour, MD, Ocular Oncology Service, Bascom Palmer Eye Institute, 900 N.W. 17th Street, Miami, FL 33136; email: harbour@miami.edu. doi: 10.3928/23258160-20190905-06
Publisher Copyright:
© 2019 Slack Incorporated. All rights reserved.
PY - 2019
Y1 - 2019
N2 - BACKGROUND AND OBJECTIVE: To describe the presentation and the authors' evolving management strategy for intraocular dissemination of uveal melanoma cells following radiotherapy during the past decade. PATIENTS AND METHODS: Patients with uveal melanoma who developed intraocular dissemination of pigmented cells following radiotherapy. Histopathology was available in two cases. RESULTS: Four patients underwent treatment for progressive intraocular dissemination of uveal melanoma cells at 9 to 41 months following I-125 plaque radiotherapy (three patients) or proton beam radiotherapy (one patient). Treatments included primary enucleation (one patient), vitrectomy followed later by enucleation (one patient), and vitrectomy followed by intravitreal chemotherapy (two patients). Enucleated eyes demonstrated diffuse invasion of intraocular tissues by viable melanoma cells. No patient has developed systemic metastasis to date. CONCLUSIONS: Intraocular dissemination of pigmented cells following radiotherapy for uveal melanoma should raise suspicion for viable invasive melanoma cells. Prompt vitrectomy with intravitreal chemotherapy can be effective in avoiding enucleation in selected cases.
AB - BACKGROUND AND OBJECTIVE: To describe the presentation and the authors' evolving management strategy for intraocular dissemination of uveal melanoma cells following radiotherapy during the past decade. PATIENTS AND METHODS: Patients with uveal melanoma who developed intraocular dissemination of pigmented cells following radiotherapy. Histopathology was available in two cases. RESULTS: Four patients underwent treatment for progressive intraocular dissemination of uveal melanoma cells at 9 to 41 months following I-125 plaque radiotherapy (three patients) or proton beam radiotherapy (one patient). Treatments included primary enucleation (one patient), vitrectomy followed later by enucleation (one patient), and vitrectomy followed by intravitreal chemotherapy (two patients). Enucleated eyes demonstrated diffuse invasion of intraocular tissues by viable melanoma cells. No patient has developed systemic metastasis to date. CONCLUSIONS: Intraocular dissemination of pigmented cells following radiotherapy for uveal melanoma should raise suspicion for viable invasive melanoma cells. Prompt vitrectomy with intravitreal chemotherapy can be effective in avoiding enucleation in selected cases.
UR - http://www.scopus.com/inward/record.url?scp=85072980773&partnerID=8YFLogxK
U2 - 10.3928/23258160-20190905-06
DO - 10.3928/23258160-20190905-06
M3 - Article
C2 - 31589755
AN - SCOPUS:85072980773
SN - 2325-8160
VL - 50
SP - 573
EP - 579
JO - Ophthalmic Surgery Lasers and Imaging Retina
JF - Ophthalmic Surgery Lasers and Imaging Retina
IS - 9
ER -