Skip to main content
SpringerLink
Log in

Okuläre Melanome

Klinik und Lokaltherapie

Ocular melanoma

Clinical and local therapy

  • Leitthema
  • Published:
Der Onkologe Aims and scope

Zusammenfassung

Es gibt 3 verschiedene Manifestationsbereiche von okulären Melanomen: Melanome der Lidhaut, Melanome der Bindehaut und intraokuläre Melanome. Melanome der Lidhaut verhalten sich klinisch und biologisch nicht anders als kutane Melanome. Erwähnenswert ist allerdings die lagebedingte Schwierigkeit ihrer Exzision. Melanome der Bindehaut sind seltene Tumoren, die meistens im Rahmen einer sog. primär erworbenen Melanose der Bindehaut und seltener aus Naevi der Bindehaut entstehen. Ihre Therapie hängt von der Ausdehnung des Tumors ab. Bei umschrieben nodulären, insbesondere limbusnahen Läsionen steht die Exzision kombiniert mit einem weiteren lokalen Therapieverfahren im Vordergrund.

Das Melanom der Uvea ist der häufigste primäre maligne intraokuläre Tumor des Menschen. Die Diagnosestellung eines malignen Melanoms der Aderhaut erfolgt durch das Zusammenspiel unterschiedlicher Untersuchungsmethoden. Standardtherapie des Aderhautmelanoms ist die Bestrahlung; in letzter Zeit kommen zunehmend Kombinationstherapien mit chirurgischer Exzision zur Anwendung.

Abstract

There are three different manifestations of ocular melanoma: melanoma of the eyelid, melanoma of the conjunctiva, and intraocular melanoma. Eyelid melanomas behave clinically and biologically as cutaneous melanomas. Noteworthy, however, is the site dependent difficulties of their excision. Conjunctival melanomas are rare and are commonly associated with a primary acquired melanosis of the conjunctiva or, less commonly, with conjunctival naevi. Treatment is dependent on the extent of the tumor. In cases of nodular and, in particular, limbus associated lesions, excision is combined with additional, local treatment.

Melanoma of the uvea is the most common primary malignant intraocular tumor in humans. The diagnosis of a melanoma of the choroid is possible using a combination of diagnostic non-invasive methods. Radiotherapy is standard for this tumor, although recently combination treatment modalities with surgical excision are more commonly applied.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Literatur

  1. Seregard S (1998) Conjunctival melanoma. Surv Ophthalmol 42:321–350

    Article  PubMed  Google Scholar 

  2. Anastassiou G, Heiligenhaus A, Bechrakis N, Bader E, Bornfeld N, Steuhl KP (2002) Prognostic value of clinical and histopathological parameters in conjunctival melanomas: a retrospective study. Br J Ophthalmol 86:163–167

    Article  PubMed  Google Scholar 

  3. Jakobiec FA, Folberg R, Iwamoto T (1989) Clinicopathologic characteristics of premalignant and malignant melanocytic lesions of the conjunctiva. Ophthalmology 96:147–166

    PubMed  Google Scholar 

  4. Norregaard JC, Gerner N, Jensen OA, Prause JU (1996) Malignant melanoma of the conjunctiva: occurrence and survival following surgery and radiotherapy in a Danish population. Graefes Arch Clin Exp Ophthalmol 234:569–572

    Article  PubMed  Google Scholar 

  5. Egan KM, Seddon JM, Glynn RJ, Gragoudas ES, Albert DM (1988) Epidemiologic aspects of uveal melanoma. Surv Ophthalmol 32:239–251

    Article  PubMed  Google Scholar 

  6. Strickland D, Lee JA (1981) Melanomas of eye: stability of rates. Am J Epidemiol 113:700–702

    PubMed  Google Scholar 

  7. Kaneko A (1982) Incidence of malignant melanoma of the eye in Japan, 1977–1979. Nippon Ganka Gakkai Zasshi 86:1042–1045

    PubMed  Google Scholar 

  8. (2003) Trends in size and treatment of recently diagnosed choroidal melanoma, 1987–1997 findings from patients examined at collaborative ocular melanoma study (COMS) centers: COMS report no. 20. Arch Ophthalmol 121:1156–1162

    Google Scholar 

  9. Seddon JM, MacLaughlin DT, Albert DM, Gragoudas ES, Ference Md (1982) Uveal melanomas presenting during pregnancy and the investigation of oestrogen receptors in melanomas. Br J Ophthalmol 66:695–704

    PubMed  Google Scholar 

  10. Egan KM, Quinn JL, Gragoudas ES (1999) Childbearing history associated with improved survival in choroidal melanoma. Arch Ophthalmol 117:939–942

    PubMed  Google Scholar 

  11. Anastassiou G, Tschentscher F, Zeschnigk M (2002) Prognostically relevant markers of malignant melanoma of the uvea. Ophthalmologe 99:327–332

    Article  PubMed  Google Scholar 

  12. Tschentscher F, Husing J, Holter T et al. (2003) Tumor Classification Based on Gene Expression Profiling Shows That Uveal Melanomas with and without Monosomy 3 Represent Two Distinct Entities. Cancer Res 63:2578–2584

    Google Scholar 

  13. Lommatzsch P (1974) Treatment of choroidal melanomas with 106Ru/106Rh beta-ray applicators. Surv Ophthalmol 19:85–100

    PubMed  Google Scholar 

  14. Puusaari I, Heikkonen J, Summanen P, Tarkkanen A, Kivela T (2003) Iodine brachytherapy as an alternative to enucleation for large uveal melanomas. Ophthalmology 110:2223–2234

    Article  PubMed  Google Scholar 

  15. Gragoudas ES, Goitein M, Koehler AM et al. (1977) Proton irradiation of small choroidal malignant melanomas. Am J Ophthalmol 83:665–673

    PubMed  Google Scholar 

  16. Hocht S, Bechrakis NE, Nausner M et al. (2004) Proton therapy of uveal melanomas in berlin 5 years of experience at the hahn-meitner institute. Strahlenther Onkol 180:419–424

    PubMed  Google Scholar 

  17. Egger E, Schalenbourg A, Zografos L, Bercher L, Boehringer T, Chamot L, Goitein G (2001) Maximizing local tumor control and survival after proton beam radiotherapy of uveal melanoma. Int J Radiat Oncol Biol Phys 51:138–147

    Article  PubMed  Google Scholar 

  18. Mueller AJ, Talies S, Schaller UC, Horstmann G, Wowra B, Kampik A (2000) Stereotactic radiosurgery of large uveal melanomas with the gamma-knife. Ophthalmology 107:1381–1387; discussion 1387–1388

    Article  PubMed  Google Scholar 

  19. Meyer-Schwickerath G (1980) Photocoagulation of choroidal melanomas. Doc Ophthalmol 50:57–61

    Article  PubMed  Google Scholar 

  20. Barr CC, Norton EW (1983) Recurrence of choroidal melanoma after photocoagulation therapy. Arch Ophthalmol 101:1737–1740

    PubMed  Google Scholar 

  21. Journee-de Korver JG, Oosterhuis JA, de Wolff-Rouendaal D, Kemme H (1997) Histopathological findings in human choroidal melanomas after transpupillary thermotherapy. Br J Ophthalmol 81:234–239

    Google Scholar 

  22. Shields CL, Shields JA, Perez N, Singh AD, Cater J (2002) Primary transpupillary thermotherapy for small choroidal melanoma in 256 consecutive cases: outcomes and limitations. Ophthalmology 109:225–234

    Article  PubMed  Google Scholar 

  23. Muller HK, Lund OE, Sollner F, Seidel G (1966) The operative treatment of tumors of the chamber angle and ciliary body. Doc Ophthalmol 20:500–518

    PubMed  Google Scholar 

  24. Foulds WS (1973) The local excision of choroidal melanomata. Trans Ophthalmol Soc UK 93:343–346

    PubMed  Google Scholar 

  25. Damato BE, Paul J, Foulds WS (1993) Predictive factors of visual outcome after local resection of choroidal melanoma. Br J Ophthalmol 77:616–623

    PubMed  Google Scholar 

  26. Bechrakis NE, Bornfeld N, Zoller I, Foerster MH (2002) Iodine 125 plaque brachytherapy versus transscleral tumor resection in the treatment of large uveal melanomas. Ophthalmology 109:1855–1861

    Article  PubMed  Google Scholar 

  27. Kivela T, Puusaari I, Damato B (2003) Transscleral resection versus iodine brachytherapy for choroidal malignant melanomas 6 millimeters or more in thickness: a matched case-control study. Ophthalmology 110:2235–2244

    Article  PubMed  Google Scholar 

  28. Peyman GA, Cohen SB (1986) Ab interno resection of uveal melanoma. Int Ophthalmol 9:29–36

    PubMed  Google Scholar 

  29. Damato B, Groenewald C, McGalliard J, Wong D (1998) Endoresection of choroidal melanoma. Br J Ophthalmol 82:213–218

    PubMed  Google Scholar 

  30. Damato B, Wong D, Green FD, Mackenzie JM (2001) Intrascleral recurrence of uveal melanoma after transretinal „endoresection“. Br J Ophthalmol 85:114–115

    Article  Google Scholar 

  31. Mittica N, Vemuganti GK, Duffy M, Torczynski E, Edward DP (2003) Late orbital recurrence of a choroidal melanoma following internal resection. Report of a case and review of the literature. Surv Ophthalmol 48:181–190

    Article  PubMed  Google Scholar 

  32. Bechrakis N, Höcht S, Martus P, Kreusel K, Heese J, Foerster M (2004) Endoresektion von großen uvealen Melanomen nach Protonenbestrahlung. Der Ophthalmologe 101:370–376

    Article  PubMed  Google Scholar 

  33. Bornfeld N, Talies S, Anastassiou G, Schilling H, Schuler A, Horstmann GA (2002) Endoresection of malignant melanomas of the uvea after preoperative stereotactic single dose convergence irradiation with the Leksell gamma knife. Ophthalmologe 99:338–344

    Article  PubMed  Google Scholar 

  34. Diener-West M, Earle JD, Fine SL et al. (2001) The COMS randomized trial of iodine 125 brachytherapy for choroidal melanoma, III: initial mortality findings. COMS Report No. 18. Arch Ophthalmol 119:969–982

    PubMed  Google Scholar 

Download references

Interessenkonflikt:

Es besteht kein Interessenkonflikt. Der korrespondierende Autor versichert, dass keine Verbindungen mit einer Firma, deren Produkt in dem Artikel genannt ist, oder einer Firma, die ein Konkurrenzprodukt vertreibt, bestehen. Die Präsentation des Themas ist unabhängig und die Darstellung der Inhalte produktneutral.

Author information

Authors and Affiliations

  1. Augenklinik Campus Benjamin Franklin, Charité, Universitätsmedizin Berlin

    N. E. Bechrakis & M. H. Foerster

  2. Abt. für Erkrankungen des hinteren Augenabschnitts, Zentrum für Augenheilkunde, Universitätsklinikum Essen

    G. Anastassiou & N. Bornfeld

  3. Augenklinik Campus Benjamin Franklin, Charité, Universitätsmedizin Berlin, Hindenburgdamm 30, 12 200 , Berlin

    N. E. Bechrakis

Authors
  1. N. E. Bechrakis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G. Anastassiou
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. N. Bornfeld
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. H. Foerster
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to N. E. Bechrakis.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bechrakis, N.E., Anastassiou, G., Bornfeld, N. et al. Okuläre Melanome. Onkologe 12, 213–221 (2006). https://doi.org/10.1007/s00761-006-1033-7

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00761-006-1033-7

Schlüsselwörter

Keywords

Search

Navigation