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- W1769496640 abstract "textabstractOphthalmic melanomas can be divided in extra-ocular (conjunctiva, caruncle) and intraocularuveal melanomas (iris, ciliary body and choroid). Uveal melanomas account for95% of ocular melanomas, while only 5% are conjunctival in origin. The extra-ocular andintra-ocular melanomas differ in biological behavior. Melanocytes originate from the neuralcrest and are normally present in the uveal stroma, similar to dermal melanocytes. Intraepithelialprecursor lesions of invasive melanoma occur in the conjunctiva and the carunclebut within the eye an intra-epithelial (retinal pigment epithelium) precursor lesion has notbetH demonstrated. Therefore a radial and vertical growth phase, as is recognized incutaneOUI> and conjunctival melanomas, is not evident in intra-ocular melanoma. Becauseuveal melanomas are not easily accessible for incisional biopsy (without disruption ofvision), only two lesions of melanocytic origin are defined clinically: nevus andmelanoma. Progression in melanoma is clinically associated with tumor size. Mostmalignant melanomas of the choroid can be diagnosed by ophthalmoscopy andultrasonography, and evidence of growth is best established by serial photography of thefundus. The uvea consists of highly vascularized tissue. There are no demonstratedlymphatics within the uveal tract, or in the posterior orbit. This explains the difference inbiological behavior of ophthalmic melanomas: conjunctival melanomas spread first toregional lymph nodes whereas choroidal and ciliary body melanomas metastasizehematogenously and preferentially first to the liver. Strikingly, another intra-ocular tumor,the retinoblastoma usually does not metastasize until after it has invaded the orbit. Fromthe orbit it gains access to lymphatic vessels in the anterior orbit. Unlike uveal melanoma,the initial metastases from retinoblastoma are often to regional lymph nodes. Uvealmelanoma metastasize relatively late: the 5, 10 and 15-year survival rates based on tumorrelateddeaths vary from 65%, 52% and 46%, respectively;' to 72%, 59% and 53%,respectively, in recent series. The estimated 5-year-survival rate of cutaneous melanomavaries between 70_80%.7.8 Once the diagnosis of hepatic metastasis from uveal melanomahas clinically been made) the median survival is extremely poor: between two 9,10 and sevenmonths, II The median survival time in patients in whom the liver was either not involved atall, or not among the first sites of dissemination is 19 months." @default.
- W1769496640 created "2016-06-24" @default.
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- W1769496640 date "1995-01-18" @default.
- W1769496640 modified "2023-09-26" @default.
- W1769496640 title "Tumor progression in uveal melanoma" @default.
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