Skip to main content

Recurrent choroidal melanoma after transscleral local resection with diffuse vitreous seeding

Graefe's Archive for Clinical and Experimental Ophthalmology volume 248, pages 741–746 (2010)Cite this article

Abstract

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.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  1. Char DH, Miller T, Crawford JB (2001) Uveal tumour resection. Br J Ophthalmol 85:1213–1219

    Article  CAS  PubMed  Google Scholar 

  2. Damato BE, Paul J, Foulds WS (1996) Risk factors for residual and recurrent uveal melanoma after trans-scleral local resection. Br J Ophthalmol 80:102–108

    Article  CAS  PubMed  Google Scholar 

  3. Shields JA, Shields CL, Shah P et al (1991) Partial lamellar sclerouvectomy for ciliary body and choroidal tumors. Ophthalmol 98:971–983

    CAS  Google Scholar 

  4. Augsburger JJ, Lauritzen K, Garnel JW et al (1990) Matched group study of surgical resection versus cobalt-60 plaque radiotherapy for primary choroidal or ciliary body melanoma. Ophthalmic Surg 21:682–688

    CAS  PubMed  Google Scholar 

  5. Kim JW, Damato BE (2002) Noncontiguous tumour recurrence of posterior uveal melanoma after transscleral local resection. Arch Ophthalmol 120:1659–1664

    PubMed  Google Scholar 

  6. Dunn WJ, Lambert M, Kincaid MC, Dieckert JP, Shore JW (1988) Choroidal malignant melanoma with early vitreous seeding. Retina 8:188–192

    Article  CAS  PubMed  Google Scholar 

  7. Spencer WH (1975) Optic nerve extension of intraocular neoplasms. Am J Ophthalmol 80:465–471

    CAS  PubMed  Google Scholar 

  8. Eagle RC, Shields JA (1982) Pseudoretinitis pigmentosa secondary to preretinal malignant melanoma cells. Retina 2:51–55

    Article  PubMed  Google Scholar 

  9. Group Collaborative Ocular Melanoma Study (1998) Histopathologic characteristics of uveal melanomas in eyes enucleated from the collaborative ocular melanoma study COMS report no. 6. Am J Ophthalmol 125:745–766

    Article  Google Scholar 

Download references

Acknowledgements

We wish to acknowledge the contribution of our friend and colleague Dr. Fiona Dolan in drafting and researching this manuscript. Sadly, she died before the manuscript could be completed. All surgery and pathology was carried out in Glasgow. The local resection surgery for cases 1 and 2 was undertaken by Professor W. Foulds. The enucleation for case 2 was undertaken by Professor B. Damato. The macro photographs and original histology of the local resection for cases 1 and 2 and the enucleation for case 2 were undertaken by Professor W.R. Lee.

Author information

Affiliations

  1. Tennent Institute of Ophthalmology, Western Infirmary, Glasgow, G11 6NT, UK

    Pedro Gonzalez, Ewan G. Kemp & Fiona Roberts

  2. Department of Pathology, Glasgow, UK

    Fiona Roberts

Authors
  1. Pedro Gonzalez
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ewan G. Kemp
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Fiona Roberts
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Fiona Roberts.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Gonzalez, P., Kemp, E.G. & Roberts, F. Recurrent choroidal melanoma after transscleral local resection with diffuse vitreous seeding. Graefes Arch Clin Exp Ophthalmol 248, 741–746 (2010). https://doi.org/10.1007/s00417-009-1261-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-009-1261-9

Keywords

  • Choroidal melanoma
  • Intraocular spread
  • Vitreous seeding