Uveal melanoma diagnosis and current treatment options (Review)

Branisteanu,Daniel Constantin; Bogdanici,Camelia Margareta; Branisteanu,Daciana Elena; Maranduca,Minela Aida; Zemba,Mihail; Balta,Florian; Branisteanu,Catalina Ioana; Moraru,Andreea Dana

doi:10.3892/etm.2021.10863

Uveal melanoma diagnosis and current treatment options (Review)

Authors:
- Daniel Constantin Branisteanu
- Camelia Margareta Bogdanici
- Daciana Elena Branisteanu
- Minela Aida Maranduca
- Mihail Zemba
- Florian Balta
- Catalina Ioana Branisteanu
- Andreea Dana Moraru
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Affiliations: Department of Ophthalmology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania, Department of Dermatology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania, Department of Physiology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania, Department of Ophthalmology, ‘Carol Davila’ University of Medicine and Pharmacy, 050474 Bucharest, Romania, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
Published online on: October 11, 2021 https://doi.org/10.3892/etm.2021.10863
Article Number: 1428
Copyright: © Branisteanu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Uveal melanoma is a rare condition accounting for only 5% of all primary melanoma cases. Still, it is the most frequently diagnosed primary intraocular malignant tumor in adults. Almost 90% of the tumors involve the choroid and only a small percentage affects the ciliary body or the iris. There is a consistent difference in incidence between different regions with individuals of northern European descent having a significantly higher risk as compared to Hispanics, Asians, and Blacks. Among the many risk factors, mutations in the G protein subunit alpha Q (GNAQ) or G protein subunit alpha 11 (GNA11) genes and different receptors are highly suggestive. While iris melanoma can easily be noticed by the patient itself or diagnosed at a routine slit‑lamp evaluation, a consistent percentage of posterior uveal tumors are incidentally diagnosed at funduscopic evaluation as they can evolve silently for years, especially if located in the periphery. Uveal melanoma classifications rely on the tumor size (thickness and basal diameter) and also on intraocular and extraocular extension. The differential diagnosis with pseudomelanomas is carried out according to the tumor aspect and position. Iris melanoma has a better prognosis and a lower mortality rate as compared to choroidal melanoma that has a much higher rate of metastasis (50% of the patients) and a subsequent limited life expectancy from 6 to 12 months. While conservative therapeutic options for the primary tumor, relying on different surgical excision techniques and/or irradiation therapies, offer good local tumor control, the treatment options for metastatic disease, although numerous, are still inadequate in preventing a fatal outcome.

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