Systemic melanoma metastatic to the retina and vitreous. 2004

Leonidas Zografos, and René-Olivier Mirimanoff, and Carlo Alberto Angeletti, and Riccardo Frosini, and Donata Beati, and Ann Schalenbourg, and Line Chamot
Clinique ophtalmologique universitaire de Lausanne, Hôpital Jules Gonin, Lausanne, Switzerland. leonidas.zografos@ophtal.vd.ch

OBJECTIVE Report of a case of retinal and vitreous metastases of a systemic melanoma, possibly arising in the lung, that responded favourably to radiotherapy. METHODS Retinal and vitreous metastases were demonstrated in a 57-year-old woman during routine follow-up after surgical resection of a melanoma presumed to be a primary pulmonary melanoma. After a 7-week observation period, which confirmed the progressive nature of the intra-ocular lesions, the patient was treated by external beam radiotherapy at a dose of 35 Gy delivered in 14 fractions of 2.5 Gy. Complete disappearance of the vitreous invasion and progressive elimination of the retinal invasion were observed over a period of 9 months. Final visual function was 20/25. REVIEW OF PUBLISHED CASES: A review of the literature identified 28 cases of melanoma with metastases to the retina and vitreous. In almost all of these cases, the primary tumour was a cutaneous melanoma and the mean patient survival following the diagnosis of intra-ocular metastases was 22 months. Retinal metastases, as in the case reported here, present a vascular tropism and tend to develop around veins. These metastases are generally unilateral and may be either solitary or multiple. Tumour invasion of the vitreous occurred by means of isolated cells forming a suspension of aggregates or spherules. Vitreous haemorrhage and irreducible neovascular glaucoma leading to functional impairment, which requires enucleation, were both the most frequent and the most serious complications of these metastases. Treatment is always palliative and is effective in cases with limited retinal and vitreous invasion, as in the case reported here. CONCLUSIONS Metastatic melanoma in the retina and vitreous is a rare entity and can lead to functional impairment and enucleation because of neovascular glaucoma. As treatment is only effective in cases with limited invasion, systematic screening is recommended in all patients with a metastatic cutaneous melanoma presenting with suggestive ocular symptoms.

UI MeSH Term Description Entries
D008175 Lung Neoplasms Tumors or cancer of the LUNG. Cancer of Lung,Lung Cancer,Pulmonary Cancer,Pulmonary Neoplasms,Cancer of the Lung,Neoplasms, Lung,Neoplasms, Pulmonary,Cancer, Lung,Cancer, Pulmonary,Cancers, Lung,Cancers, Pulmonary,Lung Cancers,Lung Neoplasm,Neoplasm, Lung,Neoplasm, Pulmonary,Pulmonary Cancers,Pulmonary Neoplasm
D008545 Melanoma A malignant neoplasm derived from cells that are capable of forming melanin, which may occur in the skin of any part of the body, in the eye, or, rarely, in the mucous membranes of the genitalia, anus, oral cavity, or other sites. It occurs mostly in adults and may originate de novo or from a pigmented nevus or malignant lentigo. Melanomas frequently metastasize widely, and the regional lymph nodes, liver, lungs, and brain are likely to be involved. The incidence of malignant skin melanomas is rising rapidly in all parts of the world. (Stedman, 25th ed; from Rook et al., Textbook of Dermatology, 4th ed, p2445) Malignant Melanoma,Malignant Melanomas,Melanoma, Malignant,Melanomas,Melanomas, Malignant
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011879 Radiotherapy Dosage The total amount of radiation absorbed by tissues as a result of radiotherapy. Dosage, Radiotherapy,Dosages, Radiotherapy,Radiotherapy Dosages
D005134 Eye Neoplasms Tumors or cancer of the EYE. Cancer of Eye,Eye Cancer,Cancer of the Eye,Neoplasms, Eye,Cancer, Eye,Cancers, Eye,Eye Cancers,Eye Neoplasm,Neoplasm, Eye
D005260 Female Females
D005451 Fluorescein Angiography Visualization of a vascular system after intravenous injection of a fluorescein solution. The images may be photographed or televised. It is used especially in studying the retinal and uveal vasculature. Fluorescence Angiography,Fundus Fluorescence Photography,Angiography, Fluorescein,Angiography, Fluorescence,Fluorescence Photography, Fundus,Photography, Fundus Fluorescence
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014463 Ultrasonography The visualization of deep structures of the body by recording the reflections or echoes of ultrasonic pulses directed into the tissues. Use of ultrasound for imaging or diagnostic purposes employs frequencies ranging from 1.6 to 10 megahertz. Echography,Echotomography,Echotomography, Computer,Sonography, Medical,Tomography, Ultrasonic,Ultrasonic Diagnosis,Ultrasonic Imaging,Ultrasonographic Imaging,Computer Echotomography,Diagnosis, Ultrasonic,Diagnostic Ultrasound,Ultrasonic Tomography,Ultrasound Imaging,Diagnoses, Ultrasonic,Diagnostic Ultrasounds,Imaging, Ultrasonic,Imaging, Ultrasonographic,Imaging, Ultrasound,Imagings, Ultrasonographic,Imagings, Ultrasound,Medical Sonography,Ultrasonic Diagnoses,Ultrasonographic Imagings,Ultrasound, Diagnostic,Ultrasounds, Diagnostic
D014794 Visual Fields The total area or space visible in a person's peripheral vision with the eye looking straightforward. Field, Visual,Fields, Visual,Visual Field

Related Publications

Leonidas Zografos, and René-Olivier Mirimanoff, and Carlo Alberto Angeletti, and Riccardo Frosini, and Donata Beati, and Ann Schalenbourg, and Line Chamot
September 2007, Archives of ophthalmology (Chicago, Ill. : 1960),
Leonidas Zografos, and René-Olivier Mirimanoff, and Carlo Alberto Angeletti, and Riccardo Frosini, and Donata Beati, and Ann Schalenbourg, and Line Chamot
January 1996, Retina (Philadelphia, Pa.),
Leonidas Zografos, and René-Olivier Mirimanoff, and Carlo Alberto Angeletti, and Riccardo Frosini, and Donata Beati, and Ann Schalenbourg, and Line Chamot
December 2015, Ocular oncology and pathology,
Leonidas Zografos, and René-Olivier Mirimanoff, and Carlo Alberto Angeletti, and Riccardo Frosini, and Donata Beati, and Ann Schalenbourg, and Line Chamot
November 1990, Australian and New Zealand journal of ophthalmology,
Leonidas Zografos, and René-Olivier Mirimanoff, and Carlo Alberto Angeletti, and Riccardo Frosini, and Donata Beati, and Ann Schalenbourg, and Line Chamot
December 1981, Ophthalmology,
Leonidas Zografos, and René-Olivier Mirimanoff, and Carlo Alberto Angeletti, and Riccardo Frosini, and Donata Beati, and Ann Schalenbourg, and Line Chamot
June 2022, American journal of ophthalmology case reports,
Leonidas Zografos, and René-Olivier Mirimanoff, and Carlo Alberto Angeletti, and Riccardo Frosini, and Donata Beati, and Ann Schalenbourg, and Line Chamot
January 2011, Retinal cases & brief reports,
Leonidas Zografos, and René-Olivier Mirimanoff, and Carlo Alberto Angeletti, and Riccardo Frosini, and Donata Beati, and Ann Schalenbourg, and Line Chamot
January 1986, Archives of ophthalmology (Chicago, Ill. : 1960),
Leonidas Zografos, and René-Olivier Mirimanoff, and Carlo Alberto Angeletti, and Riccardo Frosini, and Donata Beati, and Ann Schalenbourg, and Line Chamot
March 2007, Retina (Philadelphia, Pa.),
Leonidas Zografos, and René-Olivier Mirimanoff, and Carlo Alberto Angeletti, and Riccardo Frosini, and Donata Beati, and Ann Schalenbourg, and Line Chamot
April 1998, Ophthalmology,
Copied contents to your clipboard!