Extrascleral extension usually confers a poor prognosis. For patients with gross tumor involvement of the orbit,treatment requires orbital exenteration often combined with preoperative or postoperative radiation therapy; however,there is no evidence that this radical surgery will prolong life. Most patients with localized or encapsulated extraocular extension are not exenterated. This ...
PDQ IS A COMPREHENSIVE CANCER DATABASE AVAILABLE ON NCI'S WEB SITE. PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at NCI's Web site.
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.Editorial changes were made to this summary.
Tumor SizeUveal melanoma most often assumes a nodular or dome-shaped configuration, but occasionally tumors can be flat or diffuse and involve extensive areas of the uvea with little elevation. Tumor size classifications according to boundary lines used in a Collaborative Ocular Melanoma Study (COMS) are as follows: Small: Range from 1.0 mm to 3.0 mm in apical height and largest basal diameter of 5.0 to 16.0 mm. Medium: Range from 3.1 to 8.0 mm in apical height and a basal diameter of not more than 16.0 mm. Large: Greater than 8.0 mm in apical height or a basal diameter more than 16.0 mm, when the apical height is at least 2.0 mm.Although most ocular melanomas have a raised configuration, about 5% grow in a diffuse pattern that also may have prognostic significance. The tumors have a horizontal, flat-growth pattern, with the thickness measuring approximately 20% or less than the greatest basal dimension. This uncommon variant of uveal
Primary intraocular melanomas originate from melanocytes in the uveal tract. Four distinct cellular types are recognized in intraocular melanoma (revised Callender classification):Spindle-A cells (spindle-shaped cells with slender nuclei and lacking visible nucleoli). Spindle-B cells (spindle-shaped cells with larger nuclei and distinct nucleoli).Epithelioid cells (larger polygonal cells with one or more prominent nucleoli).Intermediate cells (similar to but smaller than epithelioid cells).Most primary intraocular melanomas contain variable proportions of epithelioid, spindle-A, and spindle-B cells (mixed-cell melanomas). Pure epithelioid-cell primary melanomas are infrequent (approximately 3% of cases). In the Collaborative Ocular Melanoma Study, mixed-cell type melanomas predominated (86% of cases).References: Klintworth GK, Scroggs MW: The eye and ocular adnexa. In: Sternberg SS, ed.: Diagnostic Surgical Pathology. Philadelphia, Pa: Lippincott Williams & Wilkins, 1999,
Basal Cell Carcinoma Treatment of basal cell carcinoma may include the following: Mohs micrographic surgery. Simple excision. Electrodesiccation and curettage. Cryosurgery. Radiation therapy. Laser surgery. Topical chemotherapy with fluorouracil. Photodynamic therapy. A clinical trial of biologic therapy. Follow-up skin exams are important for people with basal cell carcinoma because ...
Role of ObservationIris melanomas have relatively good outcomes with a 5-year survival rate of more than 95%. They are predominantly of the spindle-cell type and are usually smaller in size than posterior melanomas because of earlier detection. Conservative management is generally advocated whenever possible, but surgical intervention may be justified with unequivocal tumor growth or with extensive disease at initial examination.The management of small choroidal melanomas is controversial, and it is not clear whether treatment of small tumors prevents metastasis. The natural history of small choroidal melanoma is poorly understood. Small, pigmented, choroidal lesions cannot always be differentiated reliably on examination. Growth is a presumed indicator of malignant potential. The likelihood of progression from the time of diagnosis to the time when tumor growth warrants treatment has not been well characterized. Some ophthalmologists advocate