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Melanoma of the ciliary body
Last reviewed: 23.04.2024
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Benign tumors of the ciliary body are rarely seen, they are represented by adenoma, epithelioma, medulloepithelioma.
Malignant tumors of the ciliary body are more common.
Melanoma of the ciliary body is less than 1% of all melanoma of the choroid. The tumor develops in the fifth to sixth decades of life, but there is information in the literature about the occurrence of melanoma of the indicated localization in children. According to the morphological characteristics, this tumor is no different from melanoma of the choroid and iris, but there is a predominance of its epithelioid and mixed forms.
[Symptoms of melanoma of the ciliary body
The tumor grows slowly, can reach large sizes. Through a wide pupil, a well-delimited round-shaped knot, often of a darker color, is clearly visible. In most cases, the tumor has a mixed localization: in the iris or choroid and ciliary body. For a long period of time the disease is asymptomatic. With large tumors, patients complain of visual impairment due to deformation and dislocation of the lens. Germination of melanoma in the angle of the anterior chamber is accompanied by the formation of folds of the iris, concentric tumors, false iridodialysis. When the tumor grows into the dilator, the shape of the pupil changes. The pupil does not react to light, its edge is flattened. With the expansion of mydriatic pupils, the pupil acquires an irregular shape. Growing a tumor in the iris sometimes simulates a picture of chronic anterior uveitis. Non-pigmentary melanoma has a pinkish hue, it has well visualized its own vessels. In the sector where the tumor is localized, stagnant, convoluted episcleral vessels are seen. In the later stages of development of secondary glaucoma. The tumor can sprout the sclera, forming under the conjunctiva node, more often of a dark color.
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Treatment of ciliary melanoma
In the treatment of melanoma-localized cilia, it can be limited to its removal (partial lamellar sclerouveoctomy). Possible radiation treatment. With large tumors (occupying more than 1/3circle of the ciliary body) only enucleation of the eyeball is shown. Sprouting of the scleral capsule with the formation of subconjunctival nodes necessitates enucleation with an instrumentally proven absence of regional or haematogenic metastases.
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Prognosis for ciliary melanoma
The prognosis depends on the cellular composition and the size of the tumor. As a rule, melanomas of the ciliary body grow slowly. However, with epithelioid and mixed forms, which are observed more often than in the iris, the prognosis worsens. The ways of metastasis are the same as in choroidal melanomas.