Recurrent choroidal melanoma after transscleral local resection with diffuse vitreous seeding. 2010

Pedro Gonzalez, and Ewan G Kemp, and Fiona Roberts
Tennent Institute of Ophthalmology, Western Infirmary, Glasgow G11 6NT, UK.

BACKGROUND Choroidal melanoma usually spreads systemically via the vascular system or extraocularly through channels in the sclera. Intraocular spread through vitreous seeding is uncommon. METHODS We present two patients in whom melanoma recurred following transscleral local resection and widespread fine patchy pigmentation of the retina was identified grossly. The eyes were submitted for histological examination. RESULTS In one case there was recurrent melanoma in the surgical coloboma with diffuse vitreous seeding and a pre-retinal membrane composed of tumour cells. Tumour cells were also identified in the anterior chamber. In the second case there was no tumour in the coloboma although two small satellite choroidal nodules were identified. Tumour cells were also present in the vitreous and covering the surface of the retina. CONCLUSIONS We described two cases of recurrent choroidal melanoma following transscleral local resection with vitreous seeding. Intraocular seeding following local resection is uncommon. There are several potential mechanisms for this although it seems likely that in these cases loss of the retinal barrier assisted in the intraocular spread of these tumours.

UI MeSH Term Description Entries
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
D009364 Neoplasm Recurrence, Local The local recurrence of a neoplasm following treatment. It arises from microscopic cells of the original neoplasm that have escaped therapeutic intervention and later become clinically visible at the original site. Local Neoplasm Recurrence,Local Neoplasm Recurrences,Locoregional Neoplasm Recurrence,Neoplasm Recurrence, Locoregional,Neoplasm Recurrences, Local,Recurrence, Local Neoplasm,Recurrence, Locoregional Neoplasm,Recurrences, Local Neoplasm,Locoregional Neoplasm Recurrences,Neoplasm Recurrences, Locoregional,Recurrences, Locoregional Neoplasm
D009366 Neoplasm Seeding The local implantation of tumor cells by contamination of instruments and surgical equipment during and after surgical resection, resulting in local growth of the cells and tumor formation. Seeding, Neoplasm
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D002830 Choroid Neoplasms Tumors of the choroid; most common intraocular tumors are malignant melanomas of the choroid. These usually occur after puberty and increase in incidence with advancing age. Most malignant melanomas of the uveal tract develop from benign melanomas (nevi). Choroidal Neoplasms,Choroid Neoplasm,Choroidal Neoplasm,Neoplasm, Choroid,Neoplasm, Choroidal,Neoplasms, Choroid,Neoplasms, Choroidal
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012590 Sclera The white, opaque, fibrous, outer tunic of the eyeball, covering it entirely excepting the segment covered anteriorly by the cornea. It is essentially avascular but contains apertures for vessels, lymphatics, and nerves. It receives the tendons of insertion of the extraocular muscles and at the corneoscleral junction contains the CANAL OF SCHLEMM. (From Cline et al., Dictionary of Visual Science, 4th ed) Scleral Spur,Scleral Spurs,Scleras
D014822 Vitreous Body The transparent, semigelatinous substance that fills the cavity behind the CRYSTALLINE LENS of the EYE and in front of the RETINA. It is contained in a thin hyaloid membrane and forms about four fifths of the optic globe. Vitreous Humor,Bodies, Vitreous,Body, Vitreous,Humor, Vitreous,Humors, Vitreous,Vitreous Bodies,Vitreous Humors

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