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A case of cutaneous melanoma metastatic to the vitreous cavity: possible pathomechanism and review of the literature

  • Gesine B. JaissleEmail author
  • Peter Szurman
  • Jens Martin Rohrbach
  • Faik Gelisken
  • Karl Ulrich Bartz-Schmidt
Short Communication

Abstract

Background

Isolated vitreous metastases are extremely rare and the pathogenesis of metastasis is still unclear. Here we present the detailed description of the disease progression in a 68-year-old patient with vitreous seeding of a metastatic cutaneous melanoma beginning at a very early stage.

Methods

Interventional case report and review of the literature.

Results

The initial retrohyaloidal metastatic lesion was identified adjacent to a small epiretinal hemorrhage. As the disease progressed golden brown spherules appeared in the posterior vitreous emanating from the area of the lesion. Further progression led to a dense metastatic infiltration of the entire vitreous cavity and a decline of the visual acuity to 20/1200. Diagnostic and therapeutic pars plana vitrectomy was performed to confirm the diagnosis and preserve the eye and useful vision.

Conclusions

For the first time the formation of vitreous metastases derived from cutaneous melanoma was carefully studied beginning at a very early stage. This made it possible to analyze the rare mechanism of vitreous metastasis, which has not been conclusively known till now. The features of metastatic cutaneous melanoma to the vitreous are discussed in context of a review of the literature that resulted from the study of 17 patients with 22 affected eyes.

Keywords

Vitreous metastases Ocular metastases Cutaneous melanoma Pathomechanism Vitrectomy 

Notes

Acknowledgement

The authors thank Dr. Anja Ulmer, MD and Prof. Dr. Gerhard Fierlbeck, MD (University Dermatology Clinic, University of Tuebingen, Germany) for immunomagnetic peripheral blood analysis and for critical review of the manuscript and Dr. Barbara Wallenfels-Thilo for excellent editorial assistance.

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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Gesine B. Jaissle
    • 1
    Email author
  • Peter Szurman
    • 1
  • Jens Martin Rohrbach
    • 1
  • Faik Gelisken
    • 1
  • Karl Ulrich Bartz-Schmidt
    • 1
  1. 1.Department for Vitreoretinal SurgeryUniversity Eye HospitalTuebingenGermany

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