title: Delayed presentation of a metastatic choroidal melanoma to the liver: The latency of an elective metastatic localization.
abstract: BACKGROUND
  Choroidal melanoma is the most common primary intraocular malignant tumour and the second most common type of primary malignant melanoma in the body. Biologically, cutaneuous and ocular melanoma may be considered different, in terms of both metastatic diffusion and metastatic latency. The principal target organ for metastasis of the ocular melanoma is the liver.This distinctive behaviour is also sustained by different metastatic latency, as some patients present with metastatic ocular melanoma several years after the treatment of the primary tumor.
  
  
  METHODS
  A 60 year-old male who had undergone left ocular enucleation for choroid melanoma 20 years ago was referred to our department with a three months history of diffuse abdominal pain, fever, weight loss and massive ascites. Abdominal ultrasonography (US) and total body computed tomography (CT) scan were performed and revealed diffuse liver metastases, associated with peritoneal carcinosis, bilateral adrenal metastases and a large mass in the left kidney compatible with another secondary localization. An ultrasound guided fine needle agobiopsy (FNA) of liver lesions was performed and the pathological findings led to the diagnosis of liver metastasis from choroidal melanoma. The patient died a few weeks later for hepatic failure.
  
  
  CONCLUSIONS
  Currently, there is no consensus regarding the optimal follow-up in terms of screening modality or time interval after the treatment of the primary ocular melanoma.
  
  
  CONCLUSIONS
  Patients with gastrointestinal symptoms and a history of choroidal melanoma should be investigated for the presence of gastrointestinal or liver metastases, although the original primary malignancy was diagnosed years before the patient's presentation.
authors: Department of Surgical Sciences, Organ Transplantation and Advanced Technologies, University of Catania, Via S. Sofia 84, 95123 Catania, Italy.
authors: Antonio
authors: A
authors: Pesce
authors: Department of Surgery, University of Catania, Via S. Sofia 78, 95123 Catania, Italy. Electronic address: schaky@hotmail.it.
authors: Gaetano
authors: G
authors: Piccolo
authors: Department of Surgical Sciences, Organ Transplantation and Advanced Technologies, University of Catania, Via S. Sofia 84, 95123 Catania, Italy.
authors: Teresa Rosanna
authors: TR
authors: Portale
authors: Department of Surgical Sciences, Organ Transplantation and Advanced Technologies, University of Catania, Via S. Sofia 84, 95123 Catania, Italy.
authors: Gaetano La
authors: GL
authors: Greca
authors: Department of Surgical Sciences, Organ Transplantation and Advanced Technologies, University of Catania, Via S. Sofia 84, 95123 Catania, Italy.
authors: Stefano
authors: S
authors: Puleo
keywords: Choroidal melanoma; Gastrointestinal symptoms; Liver metastases