title: Core Endoresection as Neoadjuvant Treatment of Uveal Melanoma.
abstract: OBJECTIVE
  To present a case of neoadjuvant treatment of uveal melanoma with a limited core endoresection, which enabled ruthenium plaque radiotherapy to be administered.
  
  
  METHODS
  A 77-year-old woman presented in 2005 with a ciliochoroidal uveal melanoma measuring 7.2 by 6.5 mm basally with a thickness of 6.2 mm. The vision in the affected eye was 6/9. Because of diagnostic uncertainty, we performed a biopsy, which produced a copious sample. The biopsy serendipitously reduced the tumour thickness to 4.4 mm, making ruthenium plaque brachytherapy possible.
  
  
  RESULTS
  Histopathological examination showed the tumour to be a melanoma predominantly of spindle cell type. Postoperative complications included a dense vitreous haemorrhage, which cleared spontaneously, and raised intraocular pressure, controlled with latanoprost. Seven years after brachytherapy, the vision was 6/5 and the thickness of the residual tumour was 2.5 mm. Nine years after treatment, there was no evidence of any intra- or extraocular seeding or distant metastases.
  
  
  CONCLUSIONS
  Core endoresection of a ciliochoroidal melanoma may reduce tumour thickness enough to allow subsequent ruthenium plaque radiotherapy.
authors.affiliation: Liverpool Ocular Oncology Centre, Royal Liverpool University Hospital, Liverpool, UK; Department of Ophthalmology, Poznań University of Medical Sciences, Poznań, Poland.
authors.forename: Iwona
authors.initials: I
authors.lastname: Rospond-Kubiak
authors.affiliation: Liverpool Ocular Oncology Centre, Royal Liverpool University Hospital, Liverpool, UK.
authors.forename: Carl
authors.initials: C
authors.lastname: Groenewald
authors.affiliation: Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, UK.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Coupland
authors.affiliation: Ocular Oncology Service, Department of Ophthalmology, San Francisco, Calif., USA; Department of Radiation Oncology, University of California, San Francisco, San Francisco, Calif., USA.
authors.forename: Bertil
authors.initials: B
authors.lastname: Damato
keywords: Endoresection; Eye; Neoadjuvant treatment; Neoplasm; Uveal melanoma