Clinicopathologic findings in choroidal melanomas after failed transpupillary thermotherapy.
OBJECTIVE
To review the clinicopathologic features of eyes enucleated after failed transpupillary thermotherapy.


METHODS
Retrospective review.


METHODS
Pathology reports in the L.F. Montgomery Laboratory between 1998 and 2002 were searched for enucleated eyes with choroidal melanoma that had been treated only by transpupillary thermotherapy (TTT) prior to enucleation. The clinical features of the patients, including ultrasonography examination, were reviewed and compared with the pathologic findings.


RESULTS
Seven eyes from seven patients had been enucleated, representing 8% of eyes treated with TTT at our institute during the period studied. The primary indication for enucleation was tumor growth. The melanomas tended to grow laterally, with minimal if any increase in thickness. Five of the seven eyes histologically demonstrated extrascleral extension, which was detected by ultrasonography prior to enucleation in only one of those eyes.


CONCLUSIONS
Choroidal melanoma may continue to grow along a path of least resistance after TTT. The melanoma may extend laterally in the choroid and through emissary canals. Early extrascleral extension may be difficult to detect by ultrasonography.
Zaldivar
Renzo A
RA
Department of Ophthalmology, Emory University, Atlanta, Georgia, USA.
Aaberg
Thomas M
TM
Sternberg
Paul
P
Waldron
Rhonda
R
Grossniklaus
Hans E
HE
D000328:Adult; D000368:Aged; D002830:Choroid Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy*; D015353:Eye Enucleation; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011680:Pupil; D012189:Retrospective Studies; D017211:Treatment Failure; D014463:Ultrasonography