Reasons for secondary enucleation after eye preventing treatment of uveal melanoma

Abstract

AbstractPurpose To determine the reasons for secondary enucleation after eye preventing treatment of uveal melanoma (UM).Methods A retrospective analysis of cases of enucleation after previously treated UM. During 2007 65 patients underwent secondary enucleation ‐ 39 (60%) women and 26 (40%) men, mean age before enucleation was 54 years (range, 25‐75). The period of time between UM local treatment and enucleation planning composed 32 ± 26,7 months (range, 2‐108).Results Tumor thickness prior the enucleation was 4,36±3,5 mm and base diameter ‐ 9,8 ± 5,6 mm, before local therapy‐5,2±2,7 mm and 11,7 ± 4,3 mm, respectively. UM was localized in the choroid (43 patients, 66.1%), ciliochoroidal localization was observed in 12 (18.5%), in the iris ‐ 1 (1.5%), iridociliary ‐ 5 (7,8%), iridociliochoroidal ‐ 4 (6.1%) patients. In most cases, the patients had previously been undergone brachytherapy (45 patients, 69.2%), much less ‐ other methods: combined treatment ‐ 6 (9.2%), laser treatment ‐ 4 (6.2%), local excision ‐ 8 (12.3%), proton irradiation ‐2 (3.1%) patients. The reasons for enucleation were: continued growth ‐ 41 patients (63.1%), secondary incurable hypertension ‐ 23 (35.4%), vitreos body hemorrhage ‐ 13 (20%), extraocular extension ‐ 19 (29.2%), sclera necrosis ‐ 8 (12.3%), the residual tumor ‐ 23 (35.4%). Histologically, spindle cell tumor type was confirmed in 17 patients (26.1%), epitelioid cell UM ‐ 15 (23.1%), mixed cell UM ‐ 19 (29.2%) patients and total tumor necrosis‐ 14 (21.6%).Conclusion The most frequent causes of enucleation after previously local treatment were tumor continued growth and the presence of incompletely tumor tissue resorption. UM any location and with different cell types can be the cause of secondary enucleation.