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| Brown malignant melanoma arising in the iris of a 55 year old man |
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Uveal Tumors (iris, ciliary body, choroid) nevus |
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| Regressed retinoblastoma after chemoreduction in a 6 month old boy |
Retinal Tumors retinoblastoma |
Information on Uveal Melanoma
General
Uveal melanoma is the leading primary eye cancer in adults. It arises from a uveal nevus or de novo, without a pre-existing lesion. It often strikes without symptoms and carries a risk for spread via metastatic disease to the liver, lung, and skin. Early treatment of this eye tumor is important.
Diagnosis
The diagnosis of uveal melanoma and other uveal tumors is best made using indirect ophthalmoscopy by an experienced clinician, familiar with eye cancers and simulating tumors.
Noninvasive ancillary testing using transillumination, ocular ultrasonography, fluorescein angiography, indocyanine green angiography, ultrasound biomicroscopy, color doppler imaging and P 32 testing can be employed to confirm the diagnosis.
Fine needle biopsy is employed for difficult cases that pose diagnostic dilemma.
Risk factors for growth and metastasis of small choroidal nevi and melanoma have been identified and published by the Oncology Service. These risk factors are critical to judging the malignant potential of a small choroidal pigmented tumor.
Treatment
Many treatment methods are available including laser photocoagulation, transpupillary thermotherapy, plaque radiotherapy, partial lamellar sclerouvectomy (resection), and enucleation.
Transpupillary thermotherapy can be very effective for small tumors in the posterior part of the eye.
In general, plaque radiotherapy is used for medium sized tumors and enucleation for large tumors. Motility implants providing natural movement of the artificial eye are available.
Chemotherapy and immunotherapy regimens (using melanoma vaccine) are available.
Information on Retinoblastoma
General
Retinoblastoma is the leading eye cancer in infants and children.
Early diagnosis and treatment is important for preventing metastasis and preserving the eye and vision.
Other cancers including pinealoblastoma, osteosarcoma, and others can be associated with retinoblastoma
Diagnosis
The diagnosis of retinoblastoma and other retinal cancers is best made using indirect ophthalmoscopy by an experienced clinician, familiar with retinal cancers and simulating lesions.
Noninvasive ancillary testing using ocular ultrasonography, fluorescein angiography, computerized photographic imaging, computed tomography, and magnetic resonance imaging help to confirm the diagnosis.
Risk factors for retinoblastoma metastasis have been identified and published by the Oncology Service.
Treatment
Enucleation is a very effective method for managing retinoblastoma. A motility implant is used for all children who have enucleation and this provides movement of the artificial eye so that it appears natural.
Other eye saving treatment methods available on the Oncology Service include chemoreduction, chemothermotherapy, transpupillary thermotherapy, transcleral thermotherapy, laser photocoagulation, cryotherapy, plaque radiotherapy, and external beam radiotherapy. Subconjunctival chemotherapy is also employed in certain situations.