Choroidal melanoma in a 7-year-old child treated by trans-scleral local resection.
OBJECTIVE
To report a choroidal melanoma in a 7-year-old child treated by trans-scleral local resection and adjuvant brachytherapy with a family history of neurofibromatosis type I (NF1) and cutaneous melanoma.


METHODS
A 7-year-old child was referred for treatment of a choroidal tumor in her left eye with a differential diagnosis of melanoma, neurilemmoma, leiomyoma, and neurofibroma. Trans-scleral local resection and, subsequently, adjuvant brachytherapy were performed.


RESULTS
Histopathology and immunohistochemistry of the specimen diagnosed an amelanotic melanoma of spindle cell type, with a moderately high number of mitoses (7/40 HPF). Multiplex ligation-dependent probe amplification (MLPA) analysis showed two copies of chromosome 3, three copies of the short arm of chromosome 6, and two copies of chromosome 8, strongly suggesting a good prognosis. Postoperative ophthalmic evaluation at 6 months showed no visible tumor and flat retina with visual acuity (VA) of 6/60.


CONCLUSIONS
Trans-scleral local resection with adjuvant brachytherapy in children is possible using the same techniques as for adults. Although the follow-up is short, our patient retained the eye with good vision and our cytogenetic studies allowed us to reassure the mother.
Russo
Andrea
A
St Paul's Eye Unit, Oncology Service, Royal Liverpool University Hospital, Liverpool, UK.
Coupland
Sarah Ellen
SE
O'Keefe
Michael
M
Damato
Bertil E
BE
D001918:Brachytherapy; D002648:Child; D002830:Choroid Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008545:Melanoma / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures; D018714:Radiotherapy, Adjuvant; D012429:Ruthenium Radioisotopes / Q000627:therapeutic use; D012590:Sclera / Q000601:surgery
D012429:Ruthenium Radioisotopes