Uveal melanoma natural history, complications and prognosis

Uveal melanoma Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Uveal melanoma from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X Ray
Echocardiography and Ultrasound
CT
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Uveal melanoma natural history, complications and prognosis On the Web
Most recent articles
cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Uveal melanoma natural history, complications and prognosis All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Uveal melanoma natural history, complications and prognosis
CDC on Uveal melanoma natural history, complications and prognosis
Uveal melanoma natural history, complications and prognosis in the news
Blogs on Uveal melanoma natural history, complications and prognosis
to Hospitals Treating Uveal melanoma
Risk calculators and risk factors for Uveal melanoma natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Complications

Complications of eye melanoma may include:

Glaucoma

Eye melanoma that is growing may cause glaucoma. Signs and symptoms of glaucoma may include the following:

• Eye pain
• Redness
• Blurry vision

Vision loss

Eye melanomas that are large often cause vision loss in the affected eye and may cause complications, such as retinal detachment, that also cause vision loss. If small eye melanomas occur in critical parts of the eye they may cause some vision loss. There may be difficulty seeing in the center of the vision or on the side. Advanced eye melanomas can cause complete vision loss.

Metastasis

Eye melanoma can spread outside of the eye and to distant areas of the body, including the liver, lungs and bones.

Prognosis

Poor prognostic factors for systemic disease include:

• Older age: >60 years of age
• Larger tumors
• Anterior location within the globe
• Epithelioid cells (i.e. mixed or epithelioid histology)
• Extraocular extension
• Systemic metastases may be wide spread, with the liver > lung > bone > kidney > brain being a common sites for tumor deposits.
• Cell type is the most commonly used predictor of outcome following enucleation, with spindle-A cell melanomas carrying the best prognosis and epithelioid cell melanomas carrying the least favorable prognosis. Nevertheless, most tumors have an admixture of cell types, and there is no clear consensus regarding the proportion of epithelioid cells that constitutes designation of a tumor as mixed or epithelioid.
• Overall survival depends on tumour size, extraocular spread, and metastases. Even small (<10 mm diameter, <3 mm thickness) tumors still carry a 10-15% 5-year mortality.

Several additional microscopic features can affect the prognosis of intraocular melanoma, including:

• Mitotic activity.
• Lymphocytic infiltration.
• Fibrovascular loops
• Extraocular extension, recurrence, and metastasis are associated with an extremely poor prognosis, and long-term survival cannot be expected.
• The 5-year mortality rate associated with metastasis from ciliary body or choroidal melanoma is approximately 30%, compared with a rate of 2% to 3% for iris melanomas.