Long-term Progression in a Case of Transvitreal Endoresection of a Posterior' Choroidal Malignant Melanoma

摘要

Background: In Japan, there are few reports of the prognosis of the endoresection of malignant choroidal melanoma. We previously reported this case of transvitreal endoresection of a posterior choroidal malignant melanoma. The tumor recurred and enucleation was carried out. Here we report the subsequent long-term clinical course.Case: A choroidal tumor temporal to the macula was noted in the right eye of a 47-year-old male patient. The tumor size increased within the 1 year of observation and was suspected to be a malignant choroidal melanoma. Since the patient strongly wished to preserve his eyeball, he underwent infrared diode laser photocoagulation, resulting in further progress of the tumor. Three months later a transvitreal piecemeal endoresection was carried out. Four years after endoresection, the tumor recurred, and then the eyeball was enucleated. A pathological examination identified a spindle-cell type malignant melanoma located in the posterior part of the eyeball. No invasion was observed within the sclera or optic nerve. Neither local recurrence nor metastasis has been observed for 5 years after the enucleation.Conclusion: In this case, in spite of our utmost efforts, the eyeball could not be preserved. This case can provide useful information for considering endoresection as a management tool for choroidal melanoma.