Locally advanced choroidal melanoma with favorable molecular prognosis – case report

Abstract

Uveal malignant melanoma is a rare malignant tumor comprising less than 5% of melanoma cases. It is nevertheless the intraocular tumor with the highest incidence in adults, that arises from the melanocytes in the uveal tract. The authors present the case of a patient with locally advanced choroidal melanoma: from presentation to diagnosis, treatment, and prognosis. A 63-year-old female patient presented in the Ambulatory of the Emergency County Hospital, Craiova, Romania, on the February 1, 2021, accusing visual acuity drop and photophobia in her left eye for about three weeks. Pathology examination in Hematoxylin-Eosin (HE) staining reveals a dense cell proliferation, with small and medium spindle cells and pigment production. The following immunohistochemical markers were used in our study: human melanoma black 45 (HMB45), Ki67, cyclin D1, B-cell lymphoma 2 (Bcl2), S100, Wilms' tumor 1 (WT1), p16, and p53. Uveal melanoma is a malignant tumor that can arise in all the uveal components: iris, ciliary body, and choroid. Out of the three components, iris melanomas have the best prognosis, while ciliary body melanomas have the worst prognosis. It is mandatory for the patient to respect the follow-up schedule, as follow-ups can provide early diagnosis of eventual metastasis.

MMP1, MMP9, MMP11 and MMP13 in melanoma and its metastasis – key points in understanding the mechanisms and celerity of tumor dissemination

“…As MM metastases can occur in a high percentage of cases and hold a very unfortunate prognosis for MM patients, the time until the diagnostic of the first metastasis is a very important indicator of evolution [ 3 , 27 , 28 , 29 ]. Correlation of the MMPs expression with this indicator reveals some aspects with high significance in the patients’ management.…”

Periocular basal cell carcinoma of the eyelids – review

“…Basal squamous cell carcinoma (so-called metatypical carcinoma) is a tumour that includes mixed regions with typical basaloid differentiation and regions approaching squamous cell carcinoma. [18,43,44] An aggressive, infiltrative type of BCC showed a high expression of an apoptotic gene Bcl-2 and moderate levels of proliferation associated markers -proliferating cell nuclear antigen. [44].…”

“…[18,43,44] An aggressive, infiltrative type of BCC showed a high expression of an apoptotic gene Bcl-2 and moderate levels of proliferation associated markers -proliferating cell nuclear antigen. [44]. It was found that telomere length was shortened and gene expression correlated with cell proliferation (Bcl-2, Ki-67) was increased in BCC [45].…”

“…The primary treatment modality for BCC is surgical resection [44]. With respect to the tumour's location, tissue-sparing methods are often used, which increase the risk of recurrence [45 -48].…”

Choroidal malignant melanoma: the importance of ultrasonography

“…It roots from the melanin-producing melanocytes originating from neural crest that migrated to uvea. [1] In melanoma originating from the eye and adnexa, (82.5%) of cases were primary uveal melanoma. Around 85-90% of uveal melanoma cases arise from the choroid, 5-8% from the ciliary body, and 3-5% from the iris.…”