Multifocal iris melanoma treated with total anterior segment palladium-103 plaque radiation therapy.

Abstract

BACKGROUND:

A 73-year-old patient presented in our clinic with multiple pigmented iris nodules in the left eye. Though asymptomatic, there was a reported increase in size and number of the nodules during the past year.

METHODS:

Interventional case report describing a biopsy-proven multifocal iris melanoma treated with a palladium-103 plaque to include the entire anterior chamber within the targeted zone. Biopsy was performed utilizing a 25-gauge aspiration-cutter under viscoelastic. The cornea was protected during radiation therapy with the amniotic membrane buffer technique. Evaluation parameters included visual acuity and clinical assessments aided by slit-lamp photography as well as high-frequency ultrasound imaging.

RESULTS:

Plaque radiation therapy was well tolerated. Her visual acuity has remained within five letters at 20/25 at 1-year follow-up. Clinical evaluation revealed no evidence of corneal epitheliopathy, iris neovascularization, or visually significant cataract. High-frequency ultrasound imaging revealed a 15% reduction of the tumor's height. Serial abdominal imaging revealed no metastatic uveal melanoma.

CONCLUSIONS:

We present a biopsy-proven iris diffuse melanoma treated with palladium-103 plaque radiation therapy. Though the entire anterior segment was irradiated, there were no significant side-effects. Local tumor control was excellent during the first postoperative year.

• Authors: Vasileois Petousis, Paul T Finger, Tatyana Milman
• Journal: Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie (Graefes Arch Clin Exp Ophthalmol) Vol. 249 Issue 6 Pg. 937-40 (Jun 2011) ISSN: 1435-702X [Electronic] Germany
• PMID: 21222214 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Radioisotopes
• Palladium

Topics

• Aged
• Biopsy
• Brachytherapy
• Female
• Humans
• Iris Neoplasms (diagnostic imaging, pathology, radiotherapy)
• Melanoma (diagnostic imaging, pathology, radiotherapy)
• Neoplasms, Multiple Primary
• Palladium (therapeutic use)
• Radioisotopes (therapeutic use)
• Treatment Outcome
• Ultrasonography
• Visual Acuity (physiology)