title: Clinicopathologic report of uveal melanoma with persistent exudative retinal detachment after gamma knife radiosurgery.
abstract: OBJECTIVE
  Our purpose was to report the clinical and pathological findings from uveal melanoma patients with persistent exudative retinal detachment (RD) after Gamma Knife radiosurgery (GKR).
  
  
  METHODS
  A retrospective review was performed.
  
  
  RESULTS
  GKR was performed on 19 uveal melanoma patients from 2004 to 2006, and 5 of them developed persistent exudative RD. The mean initial largest basal tumor diameter in these 5 patients was 14.4 +/- 1.9 mm, and the mean tumor height was 9.2 +/- 1.0 mm. Marginal doses of 40-50 Gy radiation were administered. RD developed or had become aggravated an average of 3 (1-10) months after GKR. Two patients underwent enucleation, while the remaining 3 underwent tumor removal by endoresection with retinal reattachment surgery by vitrectomy and silicone oil tamponade. These procedures were undertaken an average of 6.3 (1.5-14) months after radiation and 3.3 (0.5-5) months after the onset or aggravation of RD. Histologically 4 tumors showed 50-100% necrosis without any mitotic activity. Thus local tumor control after GKR appeared sufficient regardless of RD.
  
  
  CONCLUSIONS
  Aggravation or development of exudative RD after GKR does not necessarily entail treatment failure. Therefore, retinal reattachment surgery in persistent exudative RD may be an option to preserve the eye.
authors.affiliation: Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Won Kyung
authors.initials: WK
authors.lastname: Song
authors.forename: Woo Ick
authors.initials: WI
authors.lastname: Yang
authors.forename: Suk Ho
authors.initials: SH
authors.lastname: Byeon
authors.forename: Hyoung Jun
authors.initials: HJ
authors.lastname: Koh
authors.forename: Oh Woong
authors.initials: OW
authors.lastname: Kwon
authors.forename: Sung Chul
authors.initials: SC
authors.lastname: Lee
mesh_terms: D000328:Adult; D005122:Exudates and Transudates; D015353:Eye Enucleation; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009336:Necrosis; D011183:Postoperative Complications / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D016634:Radiosurgery / Q000009:adverse effects*; D012163:Retinal Detachment / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D012827:Silicone Oils; D014604:Uveal Neoplasms / Q000473:pathology / Q000601:surgery*; D014821:Vitrectomy
chemical_list: D012827:Silicone Oils