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September 2015

Two Distinct Uveal Melanomas in the Same Eye

Author Affiliations
  • 1Liverpool Ocular Oncology Research Group, Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, England
  • 2Ocular Oncology Service, University of California, San Francisco
  • 3Liverpool Ocular Oncology Centre, Liverpool, England
JAMA Ophthalmol. 2015;133(9):1094-1096. doi:10.1001/jamaophthalmol.2015.1962

Multiple uveal melanomas (UMs) in the same eye with genetic analysis of each tumor are rarely reported.1 We present a case of 2 distinct UMs with differing molecular alterations in the same eye.

A man in his late 60s had a symptomatic, pigmented, choroidal tumor nasal to the optic disc in his left eye. The right eye was unremarkable. Medical history revealed a familial UM syndrome affecting his father and uncle (both deceased). On examination, best-corrected visual acuity was 20/20 OS and intraocular pressure was 14 mm Hg OS. On ultrasonography, the tumor measured 5.9 × 4.9 × 1.4 mm. Transpupillary thermotherapy was performed with repetition 5 months later because of incomplete tumor regression. A further 6 months later, UM regrowth was observed and was treated by proton beam therapy (dose, 5310 cGy), leading to tumor atrophy. Seven months later, intraocular bevacizumab was administered for radiation optic neuropathy. Subsequent follow-up showed a stable condition with best-corrected visual acuity of 20/127 OS.

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