Choroidal melanoma is the most common primary intraocular tumor in adults. Approximately 1,500 new cases of choroidal melanoma are diagnosed in the U.S. each year. Melanocytes, the pigment-making cells of your skin, can create melanomas and non-cancerous moles on the skin, including the eyelid.
It arises from the pigmented cells of the choroid of the eye and is not a tumor that started somewhere else and spread to the eye. A choroidal melanoma is malignant, meaning that the cancer may metastasize and eventually spread to other parts of the body. Since choroidal melanoma is inside the eye and not usually visible, patients with this disease often do not recognize its presence until the tumor grows to a size that impairs vision by obstruction, retinal detachment, hemorrhage, or other complication. Pain is unusual, except occasionally with large tumors. Periodic retinal examination through a dilated pupil is the best means of early detection.
Tests
Patients with choroidal melanoma undergoing evaluation and treatment at the Bascom Palmer Eye Institute have access to the most advanced diagnostic imaging testing and treatment modalities available currently in the United States. Using this advanced technology, we have an accuracy of diagnosis that has exceeded 99 percent in evaluation of complex ocular malignancies. We have an ongoing focus on the eradication, or elimination, of intraocular tumor associated with conserving the eye. This treatment approach allows the patient to maintain their eye with visual function in the setting of definitive treatment for their melanoma.
Advanced treatment options include focused radiotherapy, laser hyperthermia, combined application treatments including radiotherapy, hyperthermia, and surgical resection; all are options for patients for treatment at the Bascom Palmer Eye Institute.
Treatments
Treatments for choroidal melanoma usually are based on the size of the tumor.
Small Lesions - Small lesions suspicious for melanomas usually are closely watched for evidence of growth before treatment is recommended.
Medium-sized tumors - Medium-sized tumors may be treated with either radioactive plaque therapy or enucleation (removal) of the eye. The Collaborative Ocular Melanoma Study (COMS), supported by the National Eye Institute of the National Institutes of Health, has documented equal success rates for plaque radiation therapy or enucleation for preventing the spread of cancer.
Large-sized tumors - Large-size tumors usually are often treated by removing the eye (enucleation) because the amount of radiation required to treat the tumor is too much for the eye to tolerate. The COMS study found no benefit to large-size tumor patients having radiation therapy prior to enucleation. Recent advances have improved radiation therapy for all melanoma tumor types including small, medium and large ocular melanoma.
Why Choose Us?
Multidisciplinary Care Teams. You’ll have your cancer evaluated and treated by a team of eye experts. They represent several specialties: ophthalmology, dermatology, ocular oncology, radiation oncology and pathology. It adds up to personalized, well-rounded care focused on giving you an optimal quality of life.
Targeted, Precise Radiation Therapy Options. We are the only center in South Florida offering localized internal plaque radiation therapy. This treatment allows us to treat cancer without removing the eye — preserving vision, independence, and quality of life.
Leading-Edge Intra-Arterial Chemotherapy for Children with Retinoblastoma. Your child has twice the chance his or her eye will be spared. Using intra-arterial chemotherapy, we target chemotherapy directly to the eye tumor. This curative treatment has decreased the number of eye removals (for retinoblastoma) by half. It is also easier on developing bodies. Sylvester is the only center in the Southeastern U.S. and one of a few in the country that is highly skilled at this treatment.
Sylvester: One of only four designated Cancer Centers of Excellence in Florida. And as the only one located in South Florida, you will have the comfort of knowing you are in the best possible place to treat your cancer.
Bascom Palmer Eye Institute: Ranked #1 by U.S. News & World Report. Bascom Palmer Eye Institute is the top-rated facility in the country for the treatment of diseases and disorders of the eye, according to U.S. News & World Report. When you choose us for your eye care, you will receive the best care in the nation in a compassionate setting.
Top-Ranked Eye Prosthesis (Artificial Replacement) Options. More confidence and better health after cancer. If your eyeball must be removed to cure your cancer, a prosthetic eye improves your appearance and protects the space and cells behind your eye. We custom design your prosthesis to match the iris and pupil of your other eye.
A History of Firsts. We were the first center in the country to use topical interferon drops to treat eye cancer – without biopsy or surgery. This and many other research advances ensure you the best possible cancer and eye care.
Safer, More Accurate Diagnosis. Sylvester and Bascom Palmer offer ultra-high frequency OCT (optical coherence tomography). This optical ultrasound diagnoses melanomas and inner eyelid (conjunctival) tumors without biopsy or radiation.