Intraocular Tumour Spreading after Transretinal Tumour Resection of Uveal Melanoma
Bölöni R., Schüler A., Schilling H., Anastassiou G., Bornfeld N.
Purpose: Uveal melanomas are the most common primary intraocular malignancy of adults. Generally several therapeutic approaches can be applied such as enucleation, episcleral plaque brachytherapy, photocoagulation, radiotherapy, local tumour resection or internal tumour resection, also called endoresection.
Results: A 78-year old woman presented in our eye clinic with suspected uveal melanoma. No other affections were present. After examination of the anterior segments of the eye, which were normal, ophthalmoscopy revealed a fungiform uveal melanoma near the optic nerve accompanied by retinal detachment. On ultrasonography, the tumour had basal dimensions of about 9,0 mm and a thickness of 8,45 mm. Transretinal endoresection was performed with silicone oil filling of the eye and adjunctive plaque radiotherapy. 3 months later photocoagulation was applied on the central part of the margins of the scar. One further month later the silicone oil was removed and a cataract operation was performed. 6 months after endoresection a recurrence of the tumour was diagnosed which came from the inferior part of the coloboma. Plaque radiotherapy was performed again. Furthermore two other suspicious areas in the temporal part of the retina were also treated by plaque radiotherapy. Cryotherapy was applied on a third area in the upper peripheral part. 3 months later another recurrenct tumour appeared below the
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