title: Reduction of Nodular Growth Pattern of Metastatic Uveal Melanoma after Radioembolization of Hepatic Metastases.
abstract: OBJECTIVE
  The aim of this study was to report a case of metastatic uveal melanoma in which radioembolized nodular liver metastases decreased in size while infiltrative sinusoidal metastases progressed, leading to jaundice without obstruction of the biliary ducts.
  
  
  METHODS
  The relevant clinical features, imaging, and histopathologic findings of this case are reviewed.
  
  
  RESULTS
  A 61-year-old Caucasian male with a history of uveal melanoma of the left eye status post plaque brachytherapy developed numerous liver metastases. After progression on systemic therapies, he underwent palliative radioembolization. Despite some radiographic improvement in the liver metastases, he developed hyperbilirubinemia without biliary tract obstruction or signs of liver failure. A biopsy of radiographically normal liver demonstrated extensive sinusoidal infiltration with melanoma.
  
  
  CONCLUSIONS
  Distinct angiographic and histopathologic growth patterns of metastatic uveal melanoma differ in their amenability to radioembolization. Sinusoidal infiltration may lead to hyperbilirubinemia in the absence of overt obstruction or liver failure.
authors.affiliation: Emory University School of Medicine, Atlanta, Ga., USA.
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Halenda
authors.affiliation: Departments of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, Ga., USA.
authors.forename: Ragini R
authors.initials: RR
authors.lastname: Kudchadkar
authors.affiliation: Departments of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, Ga., USA.
authors.forename: David H
authors.initials: DH
authors.lastname: Lawson
authors.affiliation: Departments of Radiology and Imaging Sciences, Winship Cancer Institute of Emory University, Atlanta, Ga., USA.
authors.forename: Darren D
authors.initials: DD
authors.lastname: Kies
authors.affiliation: Department of Pathology, Winship Cancer Institute of Emory University, Atlanta, Ga., USA.
authors.forename: Kristen E
authors.initials: KE
authors.lastname: Zhelnin
authors.affiliation: Department of Pathology, Winship Cancer Institute of Emory University, Atlanta, Ga., USA.
authors.forename: Alyssa M
authors.initials: AM
authors.lastname: Krasinskas
authors.affiliation: Department of Pathology, Winship Cancer Institute of Emory University, Atlanta, Ga., USA; Department of Ophthalmology, Winship Cancer Institute of Emory University, Atlanta, Ga., USA.
authors.forename: Hans E
authors.initials: HE
authors.lastname: Grossniklaus
keywords: Liver metastasis; Micrometastases; Radioembolization; Uveal melanoma