A rapidly growing choroidal melanoma

• Published in: American journal of ophthalmology 2002-04, Vol.133 (4), p.580-581
• Main Authors: Laquis, Stephen J., Freeman, John M., Fleming, James C., Wilson, Matthew W., Haik, Barrett G.
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Choroid Neoplasms - diagnostic imaging; Choroid Neoplasms - pathology; Choroid Neoplasms - surgery; Eye Enucleation; Humans; Male; Medical sciences; Melanocytes - pathology; Melanoma - diagnostic imaging; Melanoma - pathology; Melanoma - surgery; Middle Aged; Ophthalmology; Treatment Failure; Tumors and pseudotumors of the eye, orbit, eyelid, lacrimal apparatus; Ultrasonography
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/S0002-9394(01)01399-X

PURPOSE: We describe a rapidly growing choroidal melanoma that failed to respond to consecutive globe-sparing treatments in an individual with ocular melanocytosis. DESIGN: Interventional case report. METHODS: A 53-year-old man with right ocular melanocytosis, decreased vision in the right eye, and right eye pain was referred for suspected choroidal melanoma. The lesion, which measured 2.4 mm × 6.6 mm × 6.0 mm, was treated with transpupillary thermotherapy on two occasions and with iodine-125 (I-125) plaque brachytherapy, both of which failed. Enucleation allowed histologic analysis. RESULTS: At enucleation, the choroidal melanoma in the right eye measured 13.6 mm × 16.5 mm × 16.9 mm, which demonstrated the most rapid growth and doubling time reported in a tumor of this type thus far. Pathologic analysis classified the tumor as a mixed-cell type. CONCLUSION: This case reiterates the association between ocular melanocytosis and choroidal melanoma, provides additional evidence that rapid growth and doubling time may be associated with transpupillary thermotherapy and I-125 plaque failure, and highlights the need to follow those tumors closely.