title: Multifocal iris melanoma treated with total anterior segment palladium-103 plaque radiation therapy.
abstract: BACKGROUND
  A 73-year-old patient presented in our clinic with multiple pigmented iris nodules in the left eye. Though asymptomatic, there was a reported increase in size and number of the nodules during the past year.
  
  
  METHODS
  Interventional case report describing a biopsy-proven multifocal iris melanoma treated with a palladium-103 plaque to include the entire anterior chamber within the targeted zone. Biopsy was performed utilizing a 25-gauge aspiration-cutter under viscoelastic. The cornea was protected during radiation therapy with the amniotic membrane buffer technique. Evaluation parameters included visual acuity and clinical assessments aided by slit-lamp photography as well as high-frequency ultrasound imaging.
  
  
  RESULTS
  Plaque radiation therapy was well tolerated. Her visual acuity has remained within five letters at 20/25 at 1-year follow-up. Clinical evaluation revealed no evidence of corneal epitheliopathy, iris neovascularization, or visually significant cataract. High-frequency ultrasound imaging revealed a 15% reduction of the tumor's height. Serial abdominal imaging revealed no metastatic uveal melanoma.
  
  
  CONCLUSIONS
  We present a biopsy-proven iris diffuse melanoma treated with palladium-103 plaque radiation therapy. Though the entire anterior segment was irradiated, there were no significant side-effects. Local tumor control was excellent during the first postoperative year.
authors.affiliation: The New York Eye Cancer Center, 115 East 61st Street, New York City, NY 10065, USA.
authors.forename: Vasileois
authors.initials: V
authors.lastname: Petousis
authors.forename: Paul T
authors.initials: PT
authors.lastname: Finger
authors.forename: Tatyana
authors.initials: T
authors.lastname: Milman
mesh_terms: D000368:Aged; D001706:Biopsy; D001918:Brachytherapy; D005260:Female; D006801:Humans; D015811:Iris Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*; D008545:Melanoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy*; D009378:Neoplasms, Multiple Primary; D010165:Palladium / Q000627:therapeutic use*; D011868:Radioisotopes / Q000627:therapeutic use*; D016896:Treatment Outcome; D014463:Ultrasonography; D014792:Visual Acuity / Q000502:physiology
chemical_list: D011868:Radioisotopes; D010165:Palladium