Uveal melanoma risk factors: Difference between revisions
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]
Overview
Common risk factors in the development of uveal melanoma are cutaneous and iris nevi, host pigmentation factors, ultraviolet light exposure, caucasian race, and certain inherited skin disorders such as dysplastic nevus syndrome and ocular melanocytosis.[1][2][3]
Risk Factors
Common risk factors in the development of uveal melanoma include:[1][2][3]
- Ultraviolet light exposure
- Caucasian race
- Host pigmentation factors
- Light eye color
- Fair skin color
- Propensity to sunburn
- Inherited skin disorders
- Certain inherited skin disorders such as dysplastic nevus syndrome may increase the risk of developing melanoma on skin and in eye. Some people with ocular melanocytosis with abnormal skin pigmentation involving the eyelids and adjacent tissues and increased pigmentation on their uvea have an increased risk of developing eye melanoma.
- Approximately 0.6% uveal melanomas are considered to be familial. Uveal melanomas may occur as a part of familial syndromes such as xeroderma pigmentosa, Li-Fraumeni syndrome and familial breast and ovarian cancer. Approximately 0.0017% of the primary uveal melanoma patients were in the setting of familial atypical mole and melanoma syndrome (FAMM). Patients with this syndrome were relatively young with a mean age of 40 years. An association of neurofibromatosis type 1 and uveal melanoma has also been suggested as both are of neural crest origin. Oculodermal and ocular melanocytosis, dysplastic nevi and cutaneous melanoma are associated with an increased risk of uveal melanoma development. Ocular and oculodermal melanocytosis are approximately 35 to 70 times more common in uveal melanoma patients.[4]
- Cutaneous and iris nevi
- Atypical cutaneous nevi
- Common cutaneous nevi
- Cutaneous freckles
- Iris nevi
- The risk of progression of iris nevi to melanoma at 5, 10, 15, and 20 years is 3, 4, 8, and 11 percent, respectively. Significant risks factors associated with an increased risk of transformation include younger age, inferior location, diffuse pigmentation, presence of blood in the lesion, ectropion, and a feathery margin.[5]
- Choroidal nevi
- Generally, choroidal melanoma arises in pigmented nevi. The risk of progression to melanoma at 5, 10, and 15 years is 9, 13, and 17 percent, respectively.[6]
- Significant risk factors associated with an increased risk of transformation of choroidal nevi to choroidal melanoma include the following:
- Thickness greater than 2 mm
- Subretinal fluid accumulation
- Symptoms such as decreased vision and presence of flashes or floaters
- Presence of orange pigment
- Distance from the optic nerve less than 3 mm
- Hollow rather than solid on ultrasound
- Absence of a halo.
References
- ↑ 1.0 1.1 Weis E, Shah CP, Lajous M, Shields JA, Shields CL (2009). "The association of cutaneous and iris nevi with uveal melanoma: a meta-analysis". Ophthalmology. 116 (3): 536–543.e2. doi:10.1016/j.ophtha.2008.10.008. PMID 19167086.
- ↑ 2.0 2.1 Weis E, Shah CP, Lajous M, Shields JA, Shields CL (2006). "The association between host susceptibility factors and uveal melanoma: a meta-analysis". Arch Ophthalmol. 124 (1): 54–60. doi:10.1001/archopht.124.1.54. PMID 16401785.
- ↑ 3.0 3.1 Shah CP, Weis E, Lajous M, Shields JA, Shields CL (2005). "Intermittent and chronic ultraviolet light exposure and uveal melanoma: a meta-analysis". Ophthalmology. 112 (9): 1599–607. doi:10.1016/j.ophtha.2005.04.020. PMID 16051363.
- ↑ van, J.G.M.; Koopmans, A.E.; Verdijk, R.M.; Naus, N.C.; de, A.; Kilic, E. (2013). "Diagnosis, Histopathologic and Genetic Classification of Uveal Melanoma". doi:10.5772/53631.
- ↑ Shields CL, Kaliki S, Hutchinson A, Nickerson S, Patel J, Kancherla S; et al. (2013). "Iris nevus growth into melanoma: analysis of 1611 consecutive eyes: the ABCDEF guide". Ophthalmology. 120 (4): 766–72. doi:10.1016/j.ophtha.2012.09.042. PMID 23290981.
- ↑ Shields CL, Furuta M, Berman EL, Zahler JD, Hoberman DM, Dinh DH; et al. (2009). "Choroidal nevus transformation into melanoma: analysis of 2514 consecutive cases". Arch Ophthalmol. 127 (8): 981–7. doi:10.1001/archophthalmol.2009.151. PMID 19667334.