J.ophthalmol.(Ukraine).2016;5:35-40.

Clinical characteristics of patients with choroidal melanoma of small sizes

I.V. Tsukanova, Junior Researcher Associate

Filatov Institute of Eye Diseases and Tissue Therapy, NAMS of Ukraine

Odessa, Ukraine

E-mail: inna.sister@mail.ru

Introduction. Coroidal melanomas (CM) of small sizes,  that include CM with height up to 3.0-4.0 mm, comprise 5-21% among all melanomas. According to international TNM classification (2009), T1 CM stage includes melanomas protruding into the vitreous up to 3.0 mm and having the base length up to 12.0 mm and melanomas protruding from 3.1 to 6.0 mm and having the base length up to 9.0 mm. Thus, CMs of small sizes (T I stage) refer to melanoma protruding up to 3.0 mm and having the base length up to 12.0 mm 

Since CM can be early diagnosed as result of active improvement of diagnostic methods, there is a need of an extended use of organ-sparing treatment modes, in which successful local result, so called local control, and favorable life prognosis for patients can be expected. In view of this, close investigation of different tumor characteristics which can help in choosing adequate treatment approach and in predicting its endpoint is of a great necessity and relevance. 

The purpose of the present paper was to study clinical characteristics of T1 CM stage (protruding to the vitreous up to 3.0 mm and the base length up to 12.0 mm) in patients treated at State Institition “The Filatov Institute of Eye Diseases of Tissue Therapy of NAMS of Ukraine”

Material and Methods. We studied case histories of 88 patients with CM of small sizes received medical treatment at SI “The Filatov Institute of Eye Diseases of Tissue Therapy of NAMS of Ukraine”within 2004 and 2016. 

All patients underwent standard ophthalmological and general examination Сine-Scan ultrasound sonography, liver ultrasound test, and lung fluorography/roentgenography. At the moment of referral, none of patients were revealed metastasis signs. Statistical data were processed using “Statistic 9.0” software. Mean values are given as М(SD).

Results. T 1 CM stage was observed almost 2.5  times more often in women (71.6%) as compared to men affecting working-age persons, average age 55.9 (12.8) y/o. At baseline of treatment at SI “Filatov Institute of Eye Diseases and Tissue Therapy”, CMs of small sizes were mainly of paracentral and juxtapapillary lacation, 37 (42.05%) and 26 (29.55%) patients, respectively; tumor protruding averaged 1.89(0.73) mm and mean tumor base length was 7.36 (2.2) mm. In 86 patients (96.74%) the tumor base length exceeded 3 mm. Unevenly pigmented tumors were observed rarely, only in 5 patients (5.68%). The tumor borders were indistinct in most cases (88.64%).

Conclusions. Clinical characteristics of T1 CM stage were studied at baseline on dependence of sex, lacation, size, pigmentation, and tumor growth. 

Key words: T1 stage choroidal melanoma, choroidal melanoma of small sizes, clinical characteristics

 

References

1.Vit VV. [Radiant pathomorphosis of malignant melanomas of the uveal tract of the human eye]. Oftalmol Zh. 1989;6:321-5. Russian.  

2.Ioilev EN, Fradkina IA. [Analysis of malignant tumors of the eyeball]. [Tumors and tumor-like ophthalmological diseases: proceedings]. M.;1998. 28-31. Russian. 

3.Classification of eye choroidal melanomas. Translated by Buiko AS. Oftalmol Zh. 2010;6:20-30. Russian.  

4.Panova IE, Pozdeeva OG, Semenova LE et al. [Laser surgery in the combined treatment of intraocular melanomas]. [New laser technologies in ophthalmology: Proceedings]. Kaluga; 2002. 109. Russian.  

5.Libman ES, Brovkina AF, Bezrukov AV. [Afterhistory of uveal melanoma. Comparative assessment of enucleation and organ-sparing treatment modes]. Oftalmol Zh. 1989;6:336-8. Russian.  

6.Linnik LF, Magaramov DA, Yarovoi AA, Semikova TS. [Laser transpupillar thermotherapy of choroidal melanoma].  Oftalmokhirurgiia. 2002;3:45-50. Russian. 

7.Brovkina AF, Valskii VV, Gusev GA et al. [Ophthalmic oncology]. Brovkina AF, the Editor. M.:Meditsina; 2002. 424 p. Russian.  

8.Semikova TS, Yarovoi AA. Efficacy of combined treatment of choroid melanoma. VII Congress of Ophthalmologists of Russia. Proceedings, Part II. M.; 2000: 124. Russian.  

9.BartlemaYM, Keunen JEE, Oosterhuis JA, Journee-de Korver JG. Five year follow-up of 50 patients with choroidal melanoma after combined treatment with brachytherapy and transpupillary thermotherapy. Xth International congress of ocular oncology: Final programme and abstract book.   Amsterdam, the Netherlands.  2001:  176.

10.Biswas J, Kabra S, Subramanian K, Shanmugam  M. Clinical and histopathological characteristics of uveal melanoma in asian Indians: a study of 117 patients. XI International congress of ocular oncology: programme and abstract book.  Hyderabad, India.  2004: 99. 

11.Collaborative ocular melanoma study (COMS) randomized trial of I - 125 brachytherapy for medium choroidal melanoma: I. Visual acuti after 3 years, COMS report no. 16. Ophthalmology. 2001;108:348-66.

12.Currie ZI, Rennie IG, Talbot JF. Retinal vascular changes associated with transpupillary thermotherapy for choroidal melanomas. Retina. 2002; 20(6):620-6.

13.Augsburger JJ, Correa ZM, Schneider S et al.  Diagnostic transvitreal fine - needle aspiration biopsy of small melanocyte choroidal tumors in nevus versus melanoma category. Trans. Am. Ophthalmol. Soc. 2002;100:225-32.

14.Diener-West M, Hawkins BS, Markowitz JA, Schachat AP. A review of mortality from choroidal melanoma. II. A meta - analysis of 5 - year mortality rates following enucleation, 1966 through 1988. Ophthalmol. 1992;110:245-50.

15.Shields CL, Shields JA, Karlsson U et al. Enucleation after plaque radiotherapy for posterior uveal melanoma: histopathologic findings. Ophthalmology. 1990;97(12):1665-70.

16.Saornil MA, Ordonez JL, Almaraz A et al. Epidemiologic profile of uveal melanoma patients in Spain. Xth International congress of ocular oncology: Final programme and abstract book.  Amsterdam, the Netherlands.  2001: 293. 

17.Gunduz K, Shields CL, Shields JA, Cater JR. Radiation complications and tumor control after plaque radiotherapy of choroidal melanoma with macular involvement. Am. J. Ophthalmol. 1999;127(5):579-89.

18.De Potter P, Shields CL, Shields JA et al. Impact of enucleation versus plaque radiotherapy management of juxtapapillary choroidal melanoma on patient surviva. Br. J. Ophthalmol. 1994;78:109-14.

19.Kaiserman I. Forecasting the prognosis of uveal melanoma using an artificial neural network. XI International congress of ocular oncology: programme and abstract book. Hyderabad, India. 2004: 65.

20.Kociecki J, Pecold K, Wieckowska  A. Results of treatment of intraocular malignant melanoma with diode laser transpupillary thermotherapy. Xth International congress of ocular oncology: Final programme and abstract book. Amsterdam, the Netherlands. 2001: 301.

21.Lee DS, Anderson SF, Perez EM, Townsend   JC. Amelanotic choroidal nevus and melanoma: cytology, tumor size and pigmentation as prognostic indicators. Optom. Vis. Sci. 2001;78(7):483-91.

22.Mortality in patients with small choroidal melanoma. COMS report no. 4. The Collaborative Ocular Melanoma Study Group. Arch. Ophthalmol. 1997; 115(7): 886-93. 

23.De Potter P, Shields CL, Shields JA et al. Plaque radiotherapy for juxtapapillary choroidal melanoma: visual acuity and survival outcome. Arch.   Ophthalmol. 1996;114:1357-65.

24.Augsburger JJ, Gamel JW, Shields JA et al. Post - irradiation regression of choroidal melanomas as a risk factor for death from metastatic disease. Ophthalmology.   1987;94(9):1173-7.

25.Shields CL, Shields JA, Peres N et al. Primary transpupillary thermotherapy for small choroidal melanoma in 256 consecutive cases: outcomes and limitations. Ophthalmology. 2002;109(2):225-34. 

26.Primavera V, Russo V, Laculli C, Delle N. Transpupillary thermotherapy for small choroidal melanoma: results in 25 patients. Xth International congress of ocular oncology: Final programme and abstract book. Amsterdam, the Netherlands. 2001: 292.

27.Shields CL, Shields JA, Kiratli H et al.  Risk factors for growth and metastasis of small choroidal melanocytic lesions. Ophthalmology. 1995;102(9):1351-61. 

28.Robertson DM, Buettner H, Bennett SR. Transpupillary thermotherapy as primary treatment for small choroidal melanomas. Arch. Ophthalmol. 1999;117:1512-9. 

29.Seregard S. Long - term survival after ruthenium plaque radiotherapy for uveal melanoma. A meta - analysis of studies including 1066 patients. Acta. Ophthalmol. Scand.  1999;77(4):414-7. 

30.Shields CL, Shields JA. Clinical features of small choroidal melanoma. Curr. Opin. Ophthalmol.  2002;13(3):135-41. 

31.Singh AD, Eagle RC, Shields CL, Shields JA. Enucleation following transpupillary thermotherapy of choroidal melanoma: clinicopathologic correlations. Arch. Ophthalmol.  2003;121:397-400.

32.Sambuelli R, Luna JD, Reviglio VE et al.  Small choroidal melanoma with massive extraocular extension: invasion through posterior scleral emissary channels. Int. Ophthalmol.   2001;24(4):213-8. 

33.Shields CL, Shields JA, Kiratli H et al. Transpupillary thermotherapy choroidal melanoma: tumor control and visual results in 100 consecutive cases. Ophthalmology. 1998;105(4):581-90.