TTT as rescue treatment for choroidal melanoma not controlled with iodine-125 brachytherapy

Abstract

Purpose: To describe the use of transpupillary thermotherapy in the management of two small choroidal melanomas that continued to grow following Iodine-125 brachytherapy. Methods: Case reports from a tertiary care center. Results: One small growing choroidal melanoma showed a partial response to Iodine-125 brachytherapy; four years later, it regrew to a thickness of 2.7mm. After transpupillary thermotherapy (TTT), the tumor regressed to a flat scar and has remained inactive for more than three years. A second small melanoma failed to show regression after Iodine-125 brachytherapy; it progressively grew to 3.6mm. TTT was used to treat the tumor on two successive occasions six weeks apart. The tumor regressed to a flat scar within three months and has remained inactive for 2.5 years. Conclusion: TTT may be considered as a rescue treatment for small choroidal melanomas that have failed to respond satisfactorily to brachytherapy.