Selective Intra-Arterial Embolization for Advanced Extrascleral Uveal Melanoma

Villegas, Víctor M.; Monagas, Mariola; Campbell, Joseph; Murray, Timothy G.; Serrano, Luis Santos

doi:10.1159/000477772

Cited by 2 publications

(2 citation statements)

References 12 publications

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“…16,17 TAE for advanced extrascleral uveal melanoma has to date been reported in only one patient. 18 The authors describe a female patient with a large Stage IV melanoma treated with TAE to branches of the internal and external carotid artery by coiling leading to 70% reduction in vascularity. Attempted exenteration after 1 day had to be aborted due to significant intraoperative hemorrhage but the quality of life for the patient was significantly improved due to regression in tumor size at 3 months follow-up.…”

Section: Discussionmentioning

confidence: 99%

Large Hemorrhagic Extrascleral Ciliary Body Melanoma Recurrence Treated With Transarterial Embolization and Coiling Followed by Exenteration

Weber

Flatz²,

Sommacal³

et al. 2021

Ophthalmic Plastic &Amp; Reconstructive Surgery

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A 59-year-old male patient who suffered from a systemically metastasized, large extrascleral uveal melanoma recurrence of the left eye presented with active hemorrhage from the tumor. He had undergone proton beam irradiation for an epithelioid ciliary body melanoma 4 years before presentation and was lost to follow-up. Magnetic resonance angiography showed vascularization of the lesion via the ophthalmic and maxillary artery. Selective transarterial embolization of the tumor was conducted with polyvinyl alcohol microparticles followed by coiling of the supplying arteries. The bleeding stopped after 2 days and the tumor started to become necrotic. As tumor removal was the primary wish of the patient at this point in time, exenteration was carried out a week later without significant blood loss, intraoperative or postoperative complications. Socket healing was adequate, and the patient reported improved quality of life. He refused systemic palliative treatment and died 3 months after the intervention.

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Section: Discussionmentioning

confidence: 99%

Large Hemorrhagic Extrascleral Ciliary Body Melanoma Recurrence Treated With Transarterial Embolization and Coiling Followed by Exenteration

Weber

Flatz²,

Sommacal³

et al. 2021

Ophthalmic Plastic &Amp; Reconstructive Surgery

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“…1,2 The mechanisms and risk factors leading to primary uveal melanoma continue to be elucidated. [2][3][4][5][6][7][8][9] During the last 20 years there has been widespread use of radiotherapy, either brachytherapy or charged-particle delivery for the treatment of uveal melanoma; however, significant morbidity and mortality are still associated with this disease. 10 Definitive treatment of malignant melanoma, especially small tumors, has been controversial because of the similarities with atypical uveal nevi.…”

Section: Introductionmentioning

confidence: 99%

Five-Year Follow-up of Microincisional Vitrectomy Surgery, Endolaser Tumor Ablation, and Gene-Expression Profiling in Small Uveal Melanoma

Murray

Villegas

Bach³

et al. 2020

Journal of VitreoRetinal Diseases

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Purpose: This work evaluates a microincisional vitrectomy surgical (MIVS) approach to endolaser ablation of small uveal malignant melanoma by incorporating genetic tumor classification as a means to avoid radiotherapy while maintaining local tumor control without compromising visual acuity (VA). Methods: An institutional review board–approved, single-surgeon, retrospective analysis was conducted of a consecutive case series of all patients with tumors less than 2.5 mm in apical thickness who underwent MIVS, endolaser tumor ablation, fine-needle aspiration biopsy (FNAB), and intravitreal triamcinolone acetonide for small uveal melanoma between 2012 and 2015. Results: A total of 226 patients underwent FNAB from January 2012 to January 2015 for uveal melanoma. All 58 patients treated for a small uveal melanoma were included. This group of patients had a minimum follow-up of 60 months (range, 60-93 months). At initial diagnosis, subretinal fluid was present in 52 eyes (89.1%), macular edema was present in 24 eyes (41.4%), and epiretinal membrane was present in 11 eyes (20.1%). Fifty-six specimens (96.5%) received a molecular classification of either class 2 (4 of 56, 7.1%) or class 1 (52 of 56, 92.8%). Initial VA was 20/40 or better in 26 eyes (44.8%), and final VA was 20/40 or better in 48 of 58 eyes (82.8%). Conclusions: Endolaser tumor ablation delivered at MIVS surgery enables excellent tumor control (98.3%) and improves VA to better than 20/40 in more than 80% of treated eyes. FNAB achieves molecular classification in 96.5% of all patients undergoing treatment for small choroidal melanoma independent of tumor size.

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Selective Intra-Arterial Embolization for Advanced Extrascleral Uveal Melanoma

Cited by 2 publications

References 12 publications

Large Hemorrhagic Extrascleral Ciliary Body Melanoma Recurrence Treated With Transarterial Embolization and Coiling Followed by Exenteration

Large Hemorrhagic Extrascleral Ciliary Body Melanoma Recurrence Treated With Transarterial Embolization and Coiling Followed by Exenteration

Five-Year Follow-up of Microincisional Vitrectomy Surgery, Endolaser Tumor Ablation, and Gene-Expression Profiling in Small Uveal Melanoma

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