Abstract • The liver was the organ most frequently involved in 50 patients with primary melanomas of the choroid or ciliary body, who were treated with enucleation or cobalt plaque radiotherapy and who subsequently developed systemic metastasis. Forty-seven (94%) of the patients had clinical or laboratory evidence of liver metastasis. The median survival time following treatment of the primary choroidal melanoma was 28 months (range, 7.7 to 123.1 months). Results of pretreatment studies, including serum liver enzyme levels, liver scans, or both, were abnormal in six (12%) of the patients studied. As a group, the eight patients who died within one year following ocular surgery had a significantly higher prevalence of pretreatment laboratory abnormalities. Extraocular extension of the choroidal melanoma was also present in four (50%) of these eight patients. Conversely, no patient who survived longer than the median survival period (28 months) had abnormal pretreatment laboratory findings. References 1. Shields JA: Diagnosis and Management of Intraocular Tumors . St Louis, CV Mosby Co, 1983. 2. Bedikian AY, Kantarjian H, Young SE, et al: Prognosis in metastatic choroidal melanoma . Southern Med J 1981;74:574-577.Crossref 3. Rajpal S, Moore R, Karakousis CP: Survival in metastatic ocular melanoma . Cancer 1983; 52:334-336.Crossref 4. Einhorn LH, Burgess MA, Gottlieb JA: Metastatic patterns of choroidal melanoma . Cancer 1974;34:1001-1004.Crossref 5. Char D: Metastatic choroidal melanoma . Am J Ophthalmol 1978;86:76-80. 6. Zakka K, Foos R, Omphroy C, et al: Malignant melanoma: Analysis of an autopsy population . Ophthalmology 1980;87:549-556.Crossref 7. Donoso LA, Nagy RM, Brockman RJ, et al: Metastatic uveal melanoma: Hepatic cell-surface enzymes, isoenzymes, and serum sialic acid levels in early metastatic disease . Arch Ophthalmol 1983;101:791-794.Crossref 8. Zimmerman LE, McLean IW: Metastatic disease from untreated uveal melanomas . Am J Ophthalmol 1979;88:524-534. 9. Felberg NT, Shields JA, Maguire J, et al: γ-Glutamyl transpeptidase in the prognosis of patients with uveal malignant melanoma . Am J Ophthalmol 1983;95:467-473. 10. Chisholm JF: A long-term follow-up on malignant melanomas of the choroid based on the Terry and Johns series . Am J Ophthalmol 1953;36:61-73. 11. Wheelock EF, Weinhold KJ, Levich J: The tumor dormant state . Adv Cancer Res 1981; 34:107-140. 12. Fisher B, Fisher ER: Experimental evidence in support of the dormant tumor cell . Science 1959;130:918-919.Crossref 13. Leff SR, Shields JS, Augsburger JJ: Metastatic uveal melanoma: Activation of ciliary body metastasis after abdominal surgery . Am J Ophthalmol 1985;99:209. 14. Noble RL, Hoover L: Classification of transplantable tumors in Nb rats controlled by estrogen from dormancy to autonomy . Cancer Res 1975;35:2935-2941. 15. Donoso LA, Shields JS, Augsburger JJ, et al: Metastatic uveal melanoma: Diffuse hepatic metastasis in a patient with concurrent normal serum liver enzyme levels and liver scan . Arch Ophthalmol 1985;103:758.Crossref 16. Wilhelm JL, Zakov ZN: Choroidal melanoma with liver metastasis before enucleation . Ann Ophthalmol 1982;14:789-796. 17. Moldofsky PJ, Sears HF, Mulhern CB, et al: Detection of metastatic tumor in normal-sized lymph nodes by monoclonal antibody imaging . N Engl J Med 1984;311:104-105.Crossref 18. Thompson CH, Stacker SA, Salehi N, et al: Immunoscintigraphy for detection of lymph node metastases from breast cancer . Lancet 1984; 1:1245-1247.Crossref 19. Zimmerman LE, McLean IW, Foster WD: Does enucleation of the eye containing a malignant melanoma prevent or accelerate the dissemination of tumor cells? Br J Ophthalmol 1978; 62:420-425.Crossref
Archives of Ophthalmology – American Medical Association
Published: Jun 1, 1985
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