Adults

Adults

Malignant melanoma is the most common primary malignant tumour of the eye and originates in the pigmented cells of the choroid ( Figure 49.14 ), ciliary body or iris. It can present with a reduction in vision, a vitreous haemorrhage or by the chance finding of an elevated pigmented lesion in the eye. Tumour growth is variable but, as a general rule, the more posterior the lesion, the more rapidly progressive it is likely to be. Spread may be delayed for many years; however, the liver is frequently involved, hence the advice ‘beware of the patient with a glass eye and an enlarged liver’. Treatment options vary by size and location of the tumour but include laser photocoagula - tion, radioactive plaque, radiotherapy/proton beam therapy , enucleation and, in selected cases, local excision. Diagnosis is made by direct observation and/or ultrasonography , which shows a solid tumour, often with low inter nal reflectivity on ultrasound ( Figure 49.15 ).

Figure 49.14 Choroidal melanoma. Figure 49.15 B-scan showing choroidal melanoma (courtesy of Dr Marie Reston).

Adults

Malignant melanoma is the most common primary malignant tumour of the eye and originates in the pigmented cells of the choroid ( Figure 49.14 ), ciliary body or iris. It can present with a reduction in vision, a vitreous haemorrhage or by the chance finding of an elevated pigmented lesion in the eye. Tumour growth is variable but, as a general rule, the more posterior the lesion, the more rapidly progressive it is likely to be. Spread may be delayed for many years; however, the liver is frequently involved, hence the advice ‘beware of the patient with a glass eye and an enlarged liver’. Treatment options vary by size and location of the tumour but include laser photocoagula - tion, radioactive plaque, radiotherapy/proton beam therapy , enucleation and, in selected cases, local excision. Diagnosis is made by direct observation and/or ultrasonography , which shows a solid tumour, often with low inter nal reflectivity on ultrasound ( Figure 49.15 ).

Figure 49.14 Choroidal melanoma. Figure 49.15 B-scan showing choroidal melanoma (courtesy of Dr Marie Reston).

Adults

Malignant melanoma is the most common primary malignant tumour of the eye and originates in the pigmented cells of the choroid ( Figure 49.14 ), ciliary body or iris. It can present with a reduction in vision, a vitreous haemorrhage or by the chance finding of an elevated pigmented lesion in the eye. Tumour growth is variable but, as a general rule, the more posterior the lesion, the more rapidly progressive it is likely to be. Spread may be delayed for many years; however, the liver is frequently involved, hence the advice ‘beware of the patient with a glass eye and an enlarged liver’. Treatment options vary by size and location of the tumour but include laser photocoagula - tion, radioactive plaque, radiotherapy/proton beam therapy , enucleation and, in selected cases, local excision. Diagnosis is made by direct observation and/or ultrasonography , which shows a solid tumour, often with low inter nal reflectivity on ultrasound ( Figure 49.15 ).

Figure 49.14 Choroidal melanoma. Figure 49.15 B-scan showing choroidal melanoma (courtesy of Dr Marie Reston).