Ciliary body melanoma is a type of

cancer Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal bl ...

arising from the coloured part (

uvea The uvea (; Lat. ''uva'', "grape"), also called the ''uveal layer'', ''uveal coat'', ''uveal tract'', ''vascular tunic'' or ''vascular layer'' is the pigmented middle of the three concentric layers that make up an eye. History and etymology ...

) of the

eye Eyes are organs of the visual system. They provide living organisms with vision, the ability to receive and process visual detail, as well as enabling several photo response functions that are independent of vision. Eyes detect light and conv ...

. About 12% of

uveal melanoma Uveal melanoma is a type of eye cancer in the uvea of the eye. It is traditionally classed as originating in the iris, choroid, and ciliary body, but can also be divided into class I (low metastatic risk) and class II (high metastatic risk). ...

arise from the ciliary body.

Clinical features

It occurs most commonly in the sixth decade of life. * External signs include dilated episcleral blood vessels (''sentinel vessels''). Extraocular erosion may produce a dark mass beneath the

conjunctiva The conjunctiva is a thin mucous membrane that lines the inside of the eyelids and covers the sclera (the white of the eye). It is composed of non-keratinized, stratified squamous epithelium with goblet cells, stratified columnar epitheli ...

. * Pressure on the

lens A lens is a transmissive optical device which focuses or disperses a light beam by means of refraction. A simple lens consists of a single piece of transparent material, while a compound lens consists of several simple lenses (''elements'' ...

by the enlarging tumor can cause

astigmatism Astigmatism is a type of refractive error due to rotational asymmetry in the eye's refractive power. This results in distorted or blurred vision at any distance. Other symptoms can include eyestrain, headaches, and trouble driving at ni ...

subluxation A subluxation is an incomplete or partial dislocation of a joint or organ. According to the World Health Organization (WHO), a subluxation is a "significant structural displacement", and is therefore always visible on static imaging studies, su ...

of the lens and formation of a localised lens

opacity Opacity or opaque may refer to: * Impediments to (especially, visible) light: ** Opacities, absorption coefficients ** Opacity (optics), property or degree of blocking the transmission of light * Metaphors derived from literal optics: ** In lingu ...

. * The tumor can erode forward through the iris root and mimic an iris melanoma. * Retinal detachment can be rarely caused by posterior extension of the tumor. * Anterior

uveitis Uveitis () is inflammation of the uvea, the pigmented layer of the eye between the inner retina and the outer fibrous layer composed of the sclera and cornea. The uvea consists of the middle layer of pigmented vascular structures of the eye an ...

is an uncommon presentation and occurs due to tumor

necrosis Necrosis () is a form of cell injury which results in the premature death of cells in living tissue by autolysis. Necrosis is caused by factors external to the cell or tissue, such as infection, or trauma which result in the unregulated dig ...

. * Cirumferentially growing tumors carry a bad

prognosis Prognosis (Greek: πρόγνωσις "fore-knowing, foreseeing") is a medical term for predicting the likely or expected development of a disease, including whether the signs and symptoms will improve or worsen (and how quickly) or remain stabl ...

as they are diagnosed late. * At times the tumor is detected as an incidental finding during routine examination. The tumour is usually diagnosed by clinical examination with a slit-lamp utilising a triple mirror contact lens.

Ultrasonography Ultrasound is sound waves with frequencies higher than the upper audible limit of human hearing. Ultrasound is not different from "normal" (audible) sound in its physical properties, except that humans cannot hear it. This limit varies f ...

and

fine-needle aspiration Fine-needle aspiration (FNA) is a diagnostic procedure used to investigate lumps or masses. In this technique, a thin (23–25 gauge (0.52 to 0.64 mm outer diameter)), hollow needle is inserted into the mass for sampling of cells that, aft ...

biopsy (FNAB) are also sometimes helpful in confirming the diagnosis.

Treatment

Enucleation (surgical removal of the eye) is the treatment of choice for large ciliary body melanomas. Small or medium sized tumors may be treated by an '' iridocyclectomy''.

Radiotherapy Radiation therapy or radiotherapy, often abbreviated RT, RTx, or XRT, is a therapy using ionizing radiation, generally provided as part of cancer treatment to control or kill malignant cells and normally delivered by a linear accelerator. Ra ...

may be appropriate in selected cases.

References

Ciliary Body Melanoma – Springer

Long-term survival in choroidal and ciliary body melanoma after enucleation versus plaque radiation therapy

Microvascular Density in Predicting Survival of Patients with Choroidal and Ciliary Body Melanoma

Long-term risk of local failure after proton therapy for choroidal/ciliary body melanoma

Survival, anatomic, and functional long-term results in choroidal and ciliary body melanoma after ruthenium brachytherapy (15 years’ experience with beta-rays)

Matched group study of surgical resection versus cobalt-60 plaque radiotherapy for primary... - Abstract - Europe PubMed Central
{{Eye tumors Ocular neoplasia

Clinical features

Treatment

See also

References