MICHAEL E GIBLIN FRANZCO ASIA PACIFIC SOCIETY OF OCULAR ONCOLOGY AND PATHOLOGY Uveal melanoma Iris melanoma Large Diffuse Rapid growth Hyphaema Refractory glaucoma Subjacent ciliary body involvement ID: 488213
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IMPORTANT OPHTHALMIC TUMOURS
MICHAEL E GIBLIN FRANZCO
ASIA PACIFIC SOCIETY OF OCULAR ONCOLOGY AND PATHOLOGYSlide2
Uveal melanomaSlide3
Iris melanomaLargeDiffuseRapid growth
Hyphaema
Refractory glaucomaSubjacent ciliary body involvementSlide4
Symptoms
Thickness > 2mm
Orange pigment (
lipofuscin
)
Growth
Subretinal
fluid
Peripapillary
location
Choroidal
naevus versus melanomaSlide5
MM treatment optionsObservationTranspupillary
laser thermotherapy (TTT
)
Posterior pole
Thickness < 3.5mmSlide6Slide7
Melanoma treatment optionsObservation
TTT
Local resection
Base < 10mm
Anterior to equatorSlide8
MM treatment optionsObservationTTT
Local resection
Radioactive plaque therapy
Base <15(18)mm
Thickness < 8mmSlide9
Ruthenium 106
Iodine 125Slide10
MM treatment optionsObservationTTT
Local resection
Radioactive plaque therapy
Proton beam/helium ion irradiation
Stereotactic R/T; LINAC/gamma knifeSlide11
MM treatment optionsObservationTTT
Local resection
Radioactive plaque therapy
Proton beam/helium ion irradiation
Sterertactic
radiotherapy
Enucleation
Base > 18mmSlide12
BAP1
BAP1 = BRCA Associated Protein 1
Recessive cancer suppression gene
Located on 3p21.1
Associated with monosomy 3
In
activating mutation leads to liver metastasisSlide13
Circumscribed
choroidal
haemangiomaSlide14
High internal reflectivitySlide15
Metastatic tumours
May be multifocal
Characteristically posterior to equator
Usually
amelanotic
Leopard-skin RPE spotting
Sub-retinal fluid if active
Treat if sight affected
Lung ca. Choroidal
metastasis may precede detection of primarySlide16Slide17
RetinoblastomaSlide18
Retinoblastoma
Aim for earlier detection
Chemotherapy mainstay of treatment for hereditary retinoblastoma
Incresing
role for
intraarterial
chemotherapy