Current Concepts in Uveal Melanoma (Developments in by M.J. Jager, L. Desjardins, T. Kivelä, B.E. Damato, F.

By M.J. Jager, L. Desjardins, T. Kivelä, B.E. Damato, F. Bandello

Uveal cancer is an competitive kind of melanoma which may contain the iris, the ciliary physique, and/or the choroid, that's the most position of this tumor. sufferers frequently desire to learn approximately therapy offerings and the result of assorted methods. very important present medical questions are even if a biopsy might be taken of choroidal melanomas, what will be performed with this biopsy, and even if high-risk sufferers may be screened on a regular basis. This quantity describes the medical features of uveal cancer besides different present strategies to be had for remedy, comparable to radioactive plaque therapy, proton beam treatment, and native tumor resection. in addition, options for taking biopsies and characterizing biopsy fabric are confirmed. destiny cures comparable to anti-VEGF remedy and thoughts for the remedy of metastases also are mentioned. citizens with an curiosity in ocular oncology, ophthalmologists or physicians facing uveal cancer, in addition to sufferers wishing to understand extra approximately this malignancy will discover a topical replace on uveal cancer during this ebook.

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In conclusion, treatment selection for uveal melanoma is difficult, not only because of the wide variety of clinical scenarios and the range of therapeutic options but also because there is so little guidance on the decision-making process, particularly when scientific evidence is lacking. In this chapter, I have discussed my personal approach to treatment selection and identified scope for improvement in this important aspect of patient care. References 1 Damato B: Does ocular treatment of uveal melanoma influence survival?

The tumor basal diameter is measured by funduscopy and fundus 30 Pe’er photography, preferably by using a wide-angle camera, and by B-scan ultrasonography. The tumor thickness is measured by A-scan, or, if not possible, by B-scan and high-frequency ultrasonography, or a combination thereof. The surgery for positioning the plaque over the treated tumor can be performed under either local or general anesthesia. A 360° or partial peritomy is used to expose the sclera in the tumor area. If the tumor is located under a rectus muscle insertion, the muscle should be disinserted after placing sutures to the muscle tendon and measuring the knot-to-limbus distance.

Cataract related to Ru-106 brachytherapy is the most common complication, and in one study its 2-, 3- and 5-year probability was 21, 27 and 37%, respectively [55]. The development of cataract is related to the tumor location in the anterior part of the choroid and ciliary body, when the lens is affected by direct irradiation, and to the tumor size since larger tumors receive higher doses of radiation. Cataract surgery can be performed to cure the radiation cataract. Iris neovascularization was detected in 12% of the irradiated eyes after Ru-106 brachytherapy [55].

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