Uveal Melanoma Case Study

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Although uveal melanoma is a rare malignancy, it is the most common primary intraocular tumor in adults (Kashyap, 2016) and occurs at a rate of 5.1 per million per year (Kaliki, 2016). Uveal melanoma may develop anywhere within the uveal tract, however it most commonly arises in the choroid (90%), followed by the ciliary body (6%) and then the iris (4%) (Kaliki, 2016). The at-risk population includes those with light skin, light eyes, ocular melanocytosis, nevi of the iris or choroid and the BRCA1-associated protein mutation (Kaliki, 2016). Uveal melanoma has been found to be most common in the middle-aged Caucasian population with a median age of 62 years old at presentation and with a 30% higher incidence among males relative to females…show more content…
However, occasionally it has been found to cause asymmetric astigmatism due to the displacement of the intraocular lens (Chattopadhyay, 2016). Choroidal melanoma most commonly presents as a pigmented dome-shaped mass with a mean diameter of 11.3mm and a mean thickness of 5.5mm (Kaliki, 2016).
Diagnosis
Uveal melanoma can often be diagnosed by indirect ophthalmoscopy, which may show a round mass under the retina (Kashyap, 2016). Iris and ciliary body melanoma can also be diagnosed by visualizing the anterior chamber with a slit-lamp and gonioscopy (Kaliki, 2016.) Ultrasonography can be used to diagnose larger and posterior lesions (Kashyap, 2016). Additionally, various dimensions of the melanoma can also be analyzed by fluorescein angiography, MRI, CT or by biopsy (Kashyap, 2016).
Prognosis
There are various characteristics of the tumor and a range of presenting symptoms that are associated with a higher rate of metastasis and thus a poor prognosis. Increased tumor thickness was associated with a higher rate of metastasis (Kashyap, 2016). Other features associated with increased risk of metastasis included optic disc involvement, flashes, floaters and blurred vision (Kashyap, 2016). Chromosomal abnormalities in chromosomes 1,3,6 and 8 are associated with uveal melanoma. Monosomy 3 has been found in up to 60% of patients with uveal melanoma (Chattopadhyay, 2016) and it is associated with high-risk melanoma that has a higher rate of
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