title: Metastatic melanoma after 23 years of primary ocular melanoma.
abstract: We describe a case of 52-year-old man who presented with an episode of tonic-clonic seizures. He had right ocular melanoma 23 years ago with subsequent enucleation which was the standard treatment at that time. CT scans of the brain and of the thorax-abdomen-pelvis revealed widespread metastatic lesions in the brain, lung and liver. Further investigations including bronchoscopy with cytopathology uncovered that the metastatic disease was a recurrence of ocular melanoma. He received palliative radiotherapy and died 6 months later. Ocular melanoma is often associated with fulminant metastatic disease after a period of dormancy. Thus, despite successful treatment of the localised disease at initial presentation, an effort is needed for optimal long-term follow-up plan in order to improve survival in case of recurrence.
authors.affiliation: Department of General Medicine, Midlands Regional Hospital, Portlaoise, Portlaoise, County Laois, Ireland.
authors.forename: Supriya Ramesh
authors.initials: SR
authors.lastname: Karde
authors.affiliation: Department of General Medicine, Midlands Regional Hospital, Portlaoise, Portlaoise, County Laois, Ireland.
authors.forename: Prashant Ramesh
authors.initials: PR
authors.lastname: Bhand
authors.affiliation: Department of Radiology, HSE, Portlaoise, County Laois, Ireland.
authors.forename: Nagabathula
authors.initials: N
authors.lastname: Ramesh
authors.affiliation: Department of General Medicine, Midlands Regional Hospital, Portlaoise, Portlaoise, County Laois, Ireland.
authors.forename: Sacchin
authors.initials: S
authors.lastname: Arockiam
mesh_terms: D001932:Brain Neoplasms / Q000532:radiotherapy / Q000556:secondary*; D005134:Eye Neoplasms / Q000473:pathology*; D017809:Fatal Outcome; D006801:Humans; D008113:Liver Neoplasms / Q000532:radiotherapy / Q000556:secondary*; D008175:Lung Neoplasms / Q000532:radiotherapy / Q000556:secondary*; D008297:Male; D008545:Melanoma / Q000473:pathology*; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods