Purchase this article with an account.
Myriam MacDonald, Denise Miyamoto, Erin Moriarty, Camille Zeitouni, Evangelina Esposito, Bryan Arthurs, Beatrice Wang, Miguel N Burnier; The epidemiology and clinical features of patients with both ocular and cutaneous melanomas.. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3636.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Melanoma is a life-threatening cancer derived from melanocytes with increasing incidence rates. Ocular melanoma (OM) is the leading primary intraocular malignancy in adults and nearly half of patients develop hematogenous dissemination to the liver. Cutaneous melanoma (CM) is the third most common skin cancer, with higher risk of lymphatic involvement if tumor thickness exceeds 0.8mm. The occurrence of both OM and CM in the same individual is rare. In this study we aimed to characterize the epidemiology and clinical features of patients who present with both OM and CM.
A chart review was performed including all patients with histopathologically confirmed OM at the McGill Ocular Pathology Laboratory from 2006 to 2016. Patients who were also diagnosed with CM were included in this study. Demographics, tumor characteristics and disease progression were analyzed.
Among the 61 patients with OM diagnosis, six (9,8%) fulfilled the inclusion criteria. There was a female predominance (n=5/6) and the average age at first diagnosis was 71 years. The interval between diagnoses ranged between 1-15 years. Two patients had mixed type choroidal OM with lymphocytic infiltration and 3-6 mitosis/mm2 as their initial tumor. Both patients developed metastases after enucleation; one had involvement of multiple organs including the skin after 3 years, while the other had skin and liver metastases after 4 years. Four patients first presented with CM; two had rapidly growing epithelioid ocular metastases with concomitant pulmonary lesions after 1-3.5 years. The other 2 patients had no metastases. In both of these patients, a slow growing spindle OM was diagnosed: 7 years after the CM diagnosis in the choroid in one patient, and after 15 years on the lower lid in the other, thus suggestive of new primary tumors. This latter patient had multiple primary CMs, a diffuse large B-cell lymphoma and a renal cell carcinoma in addition to a family history of melanoma. Genetic testing was performed with no evidence of mutations in genes related to familial melanoma.
Patients with OM have an increased risk of developing CM or metastatic disease, especially females. Therefore, multidisciplinary follow-up and systemic workup are recommended for early diagnosis and to confirm the nature of tumor (primary vs. metastatic).
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
This PDF is available to Subscribers Only