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Melanoma of the ciliary body
Last reviewed: 04.07.2025
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Benign tumors of the ciliary body are rare and are represented by adenoma, epithelioma, and medulloepithelioma.
Malignant tumors of the ciliary body are more common.
Ciliary body melanoma accounts for less than 1% of all choroidal melanomas. The tumor develops in the fifth to sixth decades of life, but there are reports in the literature of the occurrence of melanoma of this localization in children. In terms of morphological characteristics, this tumor is no different from choroidal and iris melanomas, but its epithelioid and mixed forms predominate.
[ Symptoms of ciliary body melanoma
The tumor grows slowly and can reach large sizes. A clearly defined round node, often dark in color, is clearly visible through a wide pupil. In most cases, the tumor has a mixed localization: in the iris or choroid and ciliary body. The disease is asymptomatic for a long period of time. With large tumors, patients complain of deterioration of vision due to deformation and dislocation of the lens. Ingrowth of melanoma into the angle of the anterior chamber is accompanied by the formation of folds of the iris, concentric with the tumor, false iridodialysis. When the tumor grows into the dilator, the shape of the pupil changes. The pupil does not react to light, its edge flattens. When dilated by mydriatics, the pupil acquires an irregular shape. Tumor ingrowth into the iris sometimes simulates the picture of chronic anterior uveitis. Amelanotic melanoma has a pinkish tint, its own vessels are well visualized. In the sector where the tumor is localized, congested, tortuous episcleral vessels are visible. In the late stages, secondary glaucoma develops. The tumor can grow into the sclera, forming a node under the conjunctiva, often dark in color.
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Treatment of melanoma of the ciliary body
In the treatment of localized melanomas of the ciliary body, its removal (partial lamellar sclerouveectomy) can be limited. Radiation therapy is possible. In case of large tumors (occupying more than 1/3circumference of the ciliary body) only enucleation of the eyeball is indicated. Tumor growth into the scleral capsule with the formation of subconjunctival nodes necessitates enucleation in the absence of regional or hematogenous metastases proven by instruments.
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Prognosis for ciliary body melanoma
The prognosis depends on the cellular composition and size of the tumor. As a rule, ciliary body melanomas grow slowly. However, with epithelioid and mixed forms, which are observed more often than in the iris, the prognosis worsens. The routes of metastasis are the same as with choroidal melanomas.