Multifocal Intraretinal Tumour Deposits following Treatment of an Ipsilateral Choroidal Melanoma.

Choroidal melanoma Metastasis Recurrence Retinal melanoma Retinoinvasive melanoma Uveal melanoma

Journal

Ocular oncology and pathology
ISSN: 2296-4681
Titre abrégé: Ocul Oncol Pathol
Pays: Switzerland
ID NLM: 101656139

Informations de publication

Date de publication:
Dec 2020
Historique:
received: 03 01 2020
accepted: 02 07 2020
entrez: 14 1 2021
pubmed: 15 1 2021
medline: 15 1 2021
Statut: ppublish

Résumé

The aim of this study was to report a patient who, following plaque brachytherapy for a choroidal melanoma, developed two separate retinal foci of malignant melanoma in the same eye, and suggest possible mechanisms that might explain such an occurrence. We conducted a retrospective case report. A 79-year-old Caucasian male developed a left inferotemporal choroidal melanoma in 2016 and subsequently underwent ruthenium-106 plaque brachytherapy under the care of the Scottish Ocular Oncology Service. Serial B-scan ultrasonography demonstrated a post-treatment reduction in tumour height to <2 mm. In 2018, 27 months after the treatment, the patient complained of a "black spot" in the centre of his left eye vision. His visual acuity had reduced to counting fingers from 6/24 (corrected Snellen visual acuity). Several new areas of pigmentation and elevation were observed, and uveal melanoma recurrence was initially suspected. Given the multifocal nature of the presentation, the multi-disciplinary team recommended enucleation. Histological examination of the enucleated eye revealed three discrete foci of malignant melanoma - the previously treated choroidal malignant melanoma, and two solitary deposits of malignant melanoma within the retina. Retinoinvasive melanoma is a rare subtype of uveal melanoma, characterised by transvitreal melanoma invasion of the retina at a site non-contiguous with the uveal tumour, which may explain the clinical and pathological findings of the reported case.

Sections du résumé

BACKGROUND/AIMS OBJECTIVE
The aim of this study was to report a patient who, following plaque brachytherapy for a choroidal melanoma, developed two separate retinal foci of malignant melanoma in the same eye, and suggest possible mechanisms that might explain such an occurrence.
METHODS METHODS
We conducted a retrospective case report.
RESULTS RESULTS
A 79-year-old Caucasian male developed a left inferotemporal choroidal melanoma in 2016 and subsequently underwent ruthenium-106 plaque brachytherapy under the care of the Scottish Ocular Oncology Service. Serial B-scan ultrasonography demonstrated a post-treatment reduction in tumour height to <2 mm. In 2018, 27 months after the treatment, the patient complained of a "black spot" in the centre of his left eye vision. His visual acuity had reduced to counting fingers from 6/24 (corrected Snellen visual acuity). Several new areas of pigmentation and elevation were observed, and uveal melanoma recurrence was initially suspected. Given the multifocal nature of the presentation, the multi-disciplinary team recommended enucleation. Histological examination of the enucleated eye revealed three discrete foci of malignant melanoma - the previously treated choroidal malignant melanoma, and two solitary deposits of malignant melanoma within the retina.
CONCLUSION CONCLUSIONS
Retinoinvasive melanoma is a rare subtype of uveal melanoma, characterised by transvitreal melanoma invasion of the retina at a site non-contiguous with the uveal tumour, which may explain the clinical and pathological findings of the reported case.

Identifiants

pubmed: 33442549
doi: 10.1159/000510575
pii: oop-0006-0410
pmc: PMC7772885
doi:

Types de publication

Case Reports

Langues

eng

Pagination

410-415

Informations de copyright

Copyright © 2020 by S. Karger AG, Basel.

Déclaration de conflit d'intérêts

The authors have no conflicts of interest to declare.

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Auteurs

Aaron Jamison (A)

Scottish Ocular Oncology Service, Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, United Kingdom.

Julie Connolly (J)

Scottish Ocular Oncology Service, Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, United Kingdom.

Paul Cauchi (P)

Scottish Ocular Oncology Service, Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, United Kingdom.

Chee Thum (C)

Department of Pathology, Queen Elizabeth University Hospital, Glasgow, United Kingdom.

Vikas Chadha (V)

Scottish Ocular Oncology Service, Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, United Kingdom.

Classifications MeSH