Abstract
Purpose:
To describe the clinical features and outcomes of patients with pain from underlying uveal melanoma.
Methods:
Retrospective case series of 9 patients.
Results:
The mean patient age at presentation was 62 years (median 62 years, range 41-83 years). The pain manifested in the periocular region (n=9) and additionally as diffuse ipsilateral headache (n=5). On a scale of 0-10, the average pain score was 7.5 (median 9, range 2-10) and four patients reported pain severity at maximum (10/10). The average duration of pain was 27 days (median 7, range 2-180 days). Visual acuity was reduced in 8 of 9 eyes. The melanoma was located in the ciliary body (n=3) or choroid (n=6). The mean tumor basal diameter was 18 mm (median 18 mm, range 14-24 mm) and mean tumor thickness was 7 mm (median 6 mm, range 5-11 mm). Clinical features of spontaneous melanoma regression was evident in all cases (n=9). Treatment included plaque radiotherapy (n=5), enucleation (n=3) and one patient refused therapy (n=1). Following therapy, all patients were relieved of pain.
Conclusions:
Ocular pain or headache can be the initial manifestation of uveal melanoma. Following ocular therapy, pain symptoms are relieved.