A rapidly growing choroidal melanoma

PURPOSE: We describe a rapidly growing choroidal melanoma that failed to respond to consecutive globe,sparing treatments in an individual with ocular melanocytosis. DESIGN: Interventional case report. METHODS: A 53 year,old man with right ocular melanocytosis, decreased vision in the right eye, and right eye pain was referred for suspected choroidal melanoma. The lesion, which measured 2.4 mm X 6.6 mm X 6.0 mm, was treated with transpupillary thermotherapy on two occasions and with iodine-125 (I-125) plaque brachy-therapy, both of which failed. Enucleation allowed histologic analysis. RESULTS: At enucleation, the choroidal melanoma in the right eye measured 13.6 mm X 16.5 mm X 16.9 mm, which demonstrated the most rapid growth and doubling time reported in a tumor of this type thus far. Pathologic analysis classified the tumor as a mixed,cell type. CONCLUSION: This case reiterates the association be tween ocular melanocytosis and choroidal melanoma, provides additional evidence that rapid growth and doubling time may be associated with transpupillary thermotherapy and 1 125 plaque failure, and highlights the need to follow those tumors closely. (C) 2002 by Elsevier Science Inc. All rights reserved.