Clinicopathologic report of uveal melanoma with persistent exudative retinal detachment after gamma knife radiosurgery.
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.
Song
Won Kyung
WK
Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Korea.
Yang
Woo Ick
WI
Byeon
Suk Ho
SH
Koh
Hyoung Jun
HJ
Kwon
Oh Woong
OW
Lee
Sung Chul
SC
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
D012827:Silicone Oils