Uveal Melanoma (Eye (Iris) Cancer)

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Uveal Melanoma (Eye (Iris) Cancer)

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Types

Uveal melanomas may arise through any of the three parts of the uvea, in addition to are sometimes referred to by their location, as Choroidal melanoma, ciliary body melanoma, or iris melanoma. Large tumors often encompass multiple parts of the uvea in addition to can be named accordingly. True iris melanomas, originating through within the iris as opposed to originating elsewhere in addition to invading the iris, are distinct in their etiology in addition to prognosis, such in which the additional tumors are often referred to collectively as Posterior uveal melanomas.

Iris melanoma

Uveal tumors can originate through melanocytes residing within the iris. Benign melanocytic tumors, such as iris freckles in addition to moles (nevi), are common in addition to pose no health risks, unless they show signs of malignancy, in which case they are classified as iris melanomas. Though derived through uveal melanocytes, iris melanomas share more in common with cutaneous (skin) melanomas, in in which they frequently harbor BRAF mutations associated with ultraviolet damage. Iris melanomas are much less likely to metastasize than additional uveal melanomas, in addition to less likely to impair vision if detected in addition to treated early.

Posterior uveal melanoma

Benign melanocytic tumors of the choroid, such as choroidal freckles in addition to nevi, are very common in addition to pose no health risks, unless they show signs of malignancy, in which case they are considered melanomas. Uveal melanoma will be distinct through most skin melanomas associated with ultraviolet exposure; however, in which shares several similarities with non-sun-exposed melanomas, such as acral melanomas in addition to mucosal melanomas. BRAF mutations are extremely rare in posterior uveal melanomas; instead, uveal melanomas frequently harbor GNAQ/GNA11 mutations, a trait shared with blue nevi, Nevus of Ota, in addition to Ocular melanosis. As seen in BRAF, mutations in GNAQ/GNA11 are early events in tumorigenesis in addition to are not prognostic for tumor stage or later metastatic spread. In contrast, mutations inside the gene BAP1 are strongly linked to metastatic spread in addition to patient survival. Incidence of posterior uveal melanoma will be highest among people with light skin in addition to blue eyes. additional risk factors, such as blue light exposure in addition to arc welding have been put forward, although are still debated inside the field. Mobile phone use will be not a risk factor for uveal melanoma.

Treatment

The treatment protocol for uveal melanoma has been directed by many clinical studies, the most important being "The Collaborative Ocular Melanoma Study" (COMS). The treatment varies depending upon many factors, chief among them, the size of the tumor. Primary treatment can involve removal of the affected eye (enucleation); however, This specific will be currently reserved for cases of extreme tumor burden or additional secondary problems. Advances in radiation therapies have significantly decreased the number of patients treated by enucleation in developed countries. The most common radiation treatment will be plaque brachytherapy, in which a modest disc-shaped shield (plaque) encasing radioactive seeds (most often Iodine-125, though Ruthenium-106 in addition to Palladium-103 are also used) will be attached to the outside surface of the eye, overlying the tumor. The plaque will be left in place for a few days in addition to then removed. The risk of metastasis after plaque radiotherapy will be the same as in which of enucleation, suggesting in which micrometastatic spread occurs prior to treatment of the primary tumor. additional modalities of treatment include transpupillary thermotherapy, external beam proton therapy, resection of the tumor, Gamma Knife stereotactic radiosurgery or a combination of different modalities. Different surgical resection techniques can include trans-scleral partial choroidectomy, in addition to transretinal endoresection.


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