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Ocular Melanoma
Daniel E. Meltzer, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Synonyms

              • Uveal melanoma, ocular adnexal melanoma, choroidal melanoma
            • Definitions

              • Primary malignancy of uveal tract (iris, ciliary body, choroid)

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Nuclear Medicine Findings

                      • Other Modality Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Staging, Grading, & Classification

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              • Image Interpretation Pearls

                                                Selected References

                                                1. Foti PV et al: Diagnostic methods and therapeutic options of uveal melanoma with emphasis on MR imaging-part I: MR imaging with pathologic correlation and technical considerations. Insights Imaging. 12(1):66, 2021
                                                2. Jonna G et al: Enhanced depth imaging OCT of ultrasonographically flat choroidal nevi demonstrates 5 distinct patterns. Ophthalmol Retina. 3(3):270-7, 2019
                                                3. Jacobsen BH et al: Ocular ultrasound versus MRI in the detection of extrascleral extension in a patient with choroidal melanoma. BMC Ophthalmol. 18(1):320, 2018
                                                4. Luke JJ et al: Biology of advanced uveal melanoma and next steps for clinical therapeutics. Pigment Cell Melanoma Res. 28(2):135-47, 2015
                                                5. Mashayekhi A et al: Primary transpupillary thermotherapy for choroidal melanoma in 391 cases: importance of risk factors in tumor control. Ophthalmology. 122(3):600-9, 2015
                                                6. Matsuo T et al: Clinicopathological correlation for the role of fluorodeoxyglucose positron emission tomography computed tomography in detection of choroidal malignant melanoma. Int J Clin Oncol. 19(2):230-9, 2014
                                                7. Shields CL et al: Enhanced depth imaging optical coherence tomography of small choroidal melanoma: comparison with choroidal nevus. Arch Ophthalmol. 130(7):850-6, 2012
                                                8. McCannel TA et al: Association of positive dual-modality positron emission tomography/computed tomography imaging of primary choroidal melanoma with chromosome 3 loss and tumor size. Retina. 30(1):146-51, 2010
                                                9. Harbour JW: Molecular prognostic testing and individualized patient care in uveal melanoma. Am J Ophthalmol. 148(6):823-9, 2009
                                                10. Modorati G et al: Gamma knife radiosurgery for uveal melanoma: 12 years of experience. Br J Ophthalmol. 93(1):40-4, 2009
                                                11. Shildkrot Y et al: Update on posterior uveal melanoma: treatment of the eye and emerging strategies in the prognosis and treatment of metastatic disease. Curr Opin Ophthalmol. 20(6):504-10, 2009
                                                12. Coupland SE et al: Routes of extraocular extension of uveal melanoma: risk factors and influence on survival probability. Ophthalmology. 115(10):1778-85, 2008
                                                13. Koutsandrea C et al: Metastasis rates and sites after treatment for choroidal melanoma by proton beam irradiation or by enucleation. Clin Ophthalmol. 2(4):989-95, 2008
                                                14. Krohn J et al: Posterior uveal melanoma. Distribution of the sites of origin and patterns of tumour extent in the ocular fundus. Br J Ophthalmol. 92(6):751-6, 2008
                                                15. Collaborative Ocular Melanoma Study Group: The COMS randomized trial of iodine 125 brachytherapy for choroidal melanoma: V. Twelve-year mortality rates and prognostic factors: COMS report No. 28. Arch Ophthalmol. 124(12):1684-93, 2006
                                                16. Lindegaard J et al: Optic nerve invasion of uveal melanoma: clinical characteristics and metastatic pattern. Invest Ophthalmol Vis Sci. 47(8):3268-75, 2006
                                                17. Reddy S et al: PET/CT imaging: detection of choroidal melanoma. Br J Ophthalmol. 89(10):1265-9, 2005
                                                18. Shields CL et al: Primary transpupillary thermotherapy for small choroidal melanoma in 256 consecutive cases: outcomes and limitations. Ophthalmology. 109(2):225-34, 2002
                                                19. Lemke AJ et al: Uveal melanoma: correlation of histopathologic and radiologic findings by using thin-section MR imaging with a surface coil. Radiology. 210(3):775-83, 1999
                                                20. Mafee MF: Uveal melanoma, choroidal hemangioma, and simulating lesions. Role of MR imaging. Radiol Clin North Am. 36(6):1083-99, 1998
                                                21. Stroszczynski C et al: Choroidal hemangioma: MR findings and differentiation from uveal melanoma. AJNR Am J Neuroradiol. 19(8):1441-7, 1998
                                                22. Hosten N et al: Uveal melanoma: detection of extraocular growth with MR imaging and US. Radiology. 202(1):61-7, 1997
                                                23. Tong KA et al: Ocular melanoma. AJNR Am J Neuroradiol. 14(6):1359-66, 1993
                                                24. McLean IW et al: Modifications of Callender's classification of uveal melanoma at the Armed Forces Institute of Pathology. Am J Ophthalmol. 96(4):502-9, 1983
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Top Differential Diagnoses

                                                      • Pathology

                                                        • Clinical Issues

                                                          TERMINOLOGY

                                                          • Synonyms

                                                            • Uveal melanoma, ocular adnexal melanoma, choroidal melanoma
                                                          • Definitions

                                                            • Primary malignancy of uveal tract (iris, ciliary body, choroid)

                                                          IMAGING

                                                          • General Features

                                                            • CT Findings

                                                              • MR Findings

                                                                • Ultrasonographic Findings

                                                                  • Nuclear Medicine Findings

                                                                    • Other Modality Findings

                                                                      • Imaging Recommendations

                                                                        DIFFERENTIAL DIAGNOSIS

                                                                          PATHOLOGY

                                                                          • General Features

                                                                            • Staging, Grading, & Classification

                                                                              • Gross Pathologic & Surgical Features

                                                                                • Microscopic Features

                                                                                  CLINICAL ISSUES

                                                                                  • Presentation

                                                                                    • Demographics

                                                                                      • Natural History & Prognosis

                                                                                        • Treatment

                                                                                          DIAGNOSTIC CHECKLIST

                                                                                          • Consider

                                                                                            • Image Interpretation Pearls

                                                                                              Selected References

                                                                                              1. Foti PV et al: Diagnostic methods and therapeutic options of uveal melanoma with emphasis on MR imaging-part I: MR imaging with pathologic correlation and technical considerations. Insights Imaging. 12(1):66, 2021
                                                                                              2. Jonna G et al: Enhanced depth imaging OCT of ultrasonographically flat choroidal nevi demonstrates 5 distinct patterns. Ophthalmol Retina. 3(3):270-7, 2019
                                                                                              3. Jacobsen BH et al: Ocular ultrasound versus MRI in the detection of extrascleral extension in a patient with choroidal melanoma. BMC Ophthalmol. 18(1):320, 2018
                                                                                              4. Luke JJ et al: Biology of advanced uveal melanoma and next steps for clinical therapeutics. Pigment Cell Melanoma Res. 28(2):135-47, 2015
                                                                                              5. Mashayekhi A et al: Primary transpupillary thermotherapy for choroidal melanoma in 391 cases: importance of risk factors in tumor control. Ophthalmology. 122(3):600-9, 2015
                                                                                              6. Matsuo T et al: Clinicopathological correlation for the role of fluorodeoxyglucose positron emission tomography computed tomography in detection of choroidal malignant melanoma. Int J Clin Oncol. 19(2):230-9, 2014
                                                                                              7. Shields CL et al: Enhanced depth imaging optical coherence tomography of small choroidal melanoma: comparison with choroidal nevus. Arch Ophthalmol. 130(7):850-6, 2012
                                                                                              8. McCannel TA et al: Association of positive dual-modality positron emission tomography/computed tomography imaging of primary choroidal melanoma with chromosome 3 loss and tumor size. Retina. 30(1):146-51, 2010
                                                                                              9. Harbour JW: Molecular prognostic testing and individualized patient care in uveal melanoma. Am J Ophthalmol. 148(6):823-9, 2009
                                                                                              10. Modorati G et al: Gamma knife radiosurgery for uveal melanoma: 12 years of experience. Br J Ophthalmol. 93(1):40-4, 2009
                                                                                              11. Shildkrot Y et al: Update on posterior uveal melanoma: treatment of the eye and emerging strategies in the prognosis and treatment of metastatic disease. Curr Opin Ophthalmol. 20(6):504-10, 2009
                                                                                              12. Coupland SE et al: Routes of extraocular extension of uveal melanoma: risk factors and influence on survival probability. Ophthalmology. 115(10):1778-85, 2008
                                                                                              13. Koutsandrea C et al: Metastasis rates and sites after treatment for choroidal melanoma by proton beam irradiation or by enucleation. Clin Ophthalmol. 2(4):989-95, 2008
                                                                                              14. Krohn J et al: Posterior uveal melanoma. Distribution of the sites of origin and patterns of tumour extent in the ocular fundus. Br J Ophthalmol. 92(6):751-6, 2008
                                                                                              15. Collaborative Ocular Melanoma Study Group: The COMS randomized trial of iodine 125 brachytherapy for choroidal melanoma: V. Twelve-year mortality rates and prognostic factors: COMS report No. 28. Arch Ophthalmol. 124(12):1684-93, 2006
                                                                                              16. Lindegaard J et al: Optic nerve invasion of uveal melanoma: clinical characteristics and metastatic pattern. Invest Ophthalmol Vis Sci. 47(8):3268-75, 2006
                                                                                              17. Reddy S et al: PET/CT imaging: detection of choroidal melanoma. Br J Ophthalmol. 89(10):1265-9, 2005
                                                                                              18. Shields CL et al: Primary transpupillary thermotherapy for small choroidal melanoma in 256 consecutive cases: outcomes and limitations. Ophthalmology. 109(2):225-34, 2002
                                                                                              19. Lemke AJ et al: Uveal melanoma: correlation of histopathologic and radiologic findings by using thin-section MR imaging with a surface coil. Radiology. 210(3):775-83, 1999
                                                                                              20. Mafee MF: Uveal melanoma, choroidal hemangioma, and simulating lesions. Role of MR imaging. Radiol Clin North Am. 36(6):1083-99, 1998
                                                                                              21. Stroszczynski C et al: Choroidal hemangioma: MR findings and differentiation from uveal melanoma. AJNR Am J Neuroradiol. 19(8):1441-7, 1998
                                                                                              22. Hosten N et al: Uveal melanoma: detection of extraocular growth with MR imaging and US. Radiology. 202(1):61-7, 1997
                                                                                              23. Tong KA et al: Ocular melanoma. AJNR Am J Neuroradiol. 14(6):1359-66, 1993
                                                                                              24. McLean IW et al: Modifications of Callender's classification of uveal melanoma at the Armed Forces Institute of Pathology. Am J Ophthalmol. 96(4):502-9, 1983