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Choroidal melanoma
Retina & Vitreous
Key Points
- •Most common primary intraocular malignancy in adults - mushroom shape on B-scan is pathognomonic; low internal reflectivity distinguishes from haemangioma (high) and naevus
- •COMS: brachytherapy equivalent to enucleation for medium melanomas (2.5–10 mm); no survival benefit from pre-enucleation EBR for large melanomas
- •Monosomy 3 is the strongest predictor of metastasis (Class 2: ~72% at 5 years); EIF1AX mutations indicate good prognosis (Class 1A: ~2%)
- •~50% develop hepatic metastases - median survival ~6–12 months; tebentafusp (IMCgp100-202 trial) is the first agent to improve OS in metastatic uveal melanoma
- •TFSOM UHHD (Shields) differentiates suspicious naevus from small melanoma: Thickness, Fluid, Symptoms, Orange pigment, Margin, Ultrasound Hollowness, Halo absent, Drusen absent
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Keep reading Choroidal melanoma
17 more sections are included with the Clinical plan.
- Definition
- Epidemiology
- Aetiology and causes
- Pathogenesis
- Classification
- Risk factors and associations