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August 24, 1984

Choroidal Melanoma and Levodopa

JAMA. 1984;252(8):1011-1012. doi:10.1001/jama.1984.03350080017013

To the Editor.— 

Report of a Case.—  A 67-year-old man with a history of parkinsonism, successfully managed with levodopa therapy since 1981, noted a superior visual field deficit in the right eye in 1982. Our evaluation disclosed an inferior choroidal malignant melanoma with a large, overlying sensory retinal detachment. Results of metastatic workups, at that time and since, have been normal. The patient was treated with placement of a cobalt 60 plaque over the tumor, delivering a total apex radiation dose of 10,000 rad over the 10-mm tumor base. During the course of the following eight months, the tumor substantially decreased in size and vision was restored.

Comment.—  The case reports by Skibba1 and others2-4 have stimulated a growing concern in the relationship between dihydroxyphenylalanine therapy and the occurrence of malignant melanoma, uveal or cutaneous. These reports discussed patients with parkinsonism treated with levodopa who subsequently suffered recurrence of

Skibba J, Pinckley J, Gilbert E, et al:  Multiple primary melanoma following administration of levodopa .  Arch Pathol Lab Med 1972;93:556.
Lieberman A, Shupack J:  Levodopa and melanoma .  Neurology 1974;24:340-343.Crossref
Sober AJ, Wick MM:  Levodopa therapy and malignant melanoma .  JAMA 1978;240:554-555.Crossref
Van Rens G, DeJong P, Demols E:  Uveal malignant melanoma and levodopa therapy in Parkinson's disease .  Ophthalmology 1982;89:1464.
Dorner M, Reich E:  Oxidative phosphorylation and some related phenomena in pigment granules of mouse melanomas .  Biochem Biophys Acta 1961;48:534.Crossref