Skip to main content
PMC home page
The British Journal of Ophthalmology logoLink to The British Journal of Ophthalmology
. 1978 Jun;62(6):420–425. doi: 10.1136/bjo.62.6.420

Does enucleation of the eye containing a malignant melanoma prevent or accelerate the dissemination of tumour cells.

L E Zimmerman, I W McLean, W D Foster
PMCID: PMC1043246  PMID: 352389

Abstract

A reappraisal of survival data on patients with uveal melanomas has led us to these impressions: (a) that the mortality rate before enucleation is low, estimated at 1% per year; (b) that the mortality rate rises abruptly following enucleation, reaching a peak of about 8% during the second year after enucleation; and (c) that approximately two-thirds of the fatalities could be attributed to the dissemination of tumour emboli at the time of enucleation. From these impressions we believe the following conclusions are warranted: (a) enucleation as it has been performed in the past may have for many patients an adverse rather than a beneficial effect with respect to the development of metastatic disease from malignant melanoma of the choroid and ciliary body. (b) A long-term follow-up study of untreated patients with melanomas of the choroid and ciliary body is indicated. (c) New techniques for enucleation designed to prevent the dissemination of tumour cells must be developed and tested to enable the ophthalmic surgeon to remove safely the tumour-containing eye that has developed such complications as uncontrollable glaucoma, panophthalmitis, or proptosis from extraocular extension.

Full text

PDF

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ADLER F. H., ZIMMERMAN L. E. Clinical pathologic conference. Am J Ophthalmol. 1957 Feb;43(2):223–231. doi: 10.1016/0002-9394(57)92914-8. [DOI] [PubMed] [Google Scholar]
  2. ANDERSON B., O'NEILL J. Malignant melanoma of the uvea; observations on growth and behavior, enucleation refused or delayed. AMA Arch Ophthalmol. 1957 Sep;58(3):337–347. [PubMed] [Google Scholar]
  3. ASHTON N. PRIMARY TUMOURS OF THE IRIS. Br J Ophthalmol. 1964 Dec;48:650–668. doi: 10.1136/bjo.48.12.650. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. BURNS R. P., FRAUNFELDER F. T., KLASS A. M. A laboratory evaluation of enucleation in treatment of intraocular malignant melanoma. Arch Ophthalmol. 1962 Apr;67:490–500. doi: 10.1001/archopht.1962.00960020490019. [DOI] [PubMed] [Google Scholar]
  5. Benjamin B., Cumings J. N., Goldsmith A. J., Sorsby A. PROGNOSIS IN UVEAL MELANOMA. Br J Ophthalmol. 1948 Oct;32(10):729–747. [PMC free article] [PubMed] [Google Scholar]
  6. Blomquist C. D. From the Oath of Hippocrates to the Declaration of Hawaii. Introductory essay to a draft of an international code of ethics for psychiatrists prepared for the World Psychiatric Association and the CIBA Foundation meeting on the ethical aspects of psychiatry, London, June 1976. Ethics Sci Med. 1977;4(3-4):139–149. [PubMed] [Google Scholar]
  7. CHISHOLM J. F., Jr A long term follow-up on malignant melanomas of the choroid based on the Terry and Johns series. Am J Ophthalmol. 1953 Jan;36(1):61–75. doi: 10.1016/0002-9394(53)91509-8. [DOI] [PubMed] [Google Scholar]
  8. Char D. H., Hogan M. J. Management of small elevated pigmented choroidal lesions. Br J Ophthalmol. 1977 Jan;61(1):54–58. doi: 10.1136/bjo.61.1.54. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. FLOCKS M., GERENDE J. H., ZIMMERMAN L. E. The size and shape of malignant melanomas of the choroid and ciliary body in relation to prognosis and histologic characteristics; a statistical study of 210 tumors. Trans Am Acad Ophthalmol Otolaryngol. 1955 Nov-Dec;59(6):740–758. [PubMed] [Google Scholar]
  10. Fraunfelder F. T., Boozman F. W., Wilson R. S., Thomas A. H. No-touch technique for intraocular malignant melanomas. Arch Ophthalmol. 1977 Sep;95(9):1616–1620. doi: 10.1001/archopht.1977.04450090138012. [DOI] [PubMed] [Google Scholar]
  11. Gass J. D. Problems in the differential diagnosis of choroidal nevi and malignant melanomas. The XXXIII Edward Jackson Memorial Lecture. Am J Ophthalmol. 1977 Mar;83(3):299–323. doi: 10.1089/ten.2005.11.1254. [DOI] [PubMed] [Google Scholar]
  12. Hagler W. S., Jarrett W. H., 2nd, Killian J. H. The use of the 32P test in the management of malignant melanoma of the choroid: a five-year follow-up study. Trans Sect Ophthalmol Am Acad Ophthalmol Otolaryngol. 1977 Jan-Feb;83(1):49–60. [PubMed] [Google Scholar]
  13. KOENIG I. J. Malignant melanoma of the iris and ciliary body of a one-eyed patient; case observed for twenty years. AMA Arch Ophthalmol. 1954 May;51(5):656–662. doi: 10.1001/archopht.1954.00920040666009. [DOI] [PubMed] [Google Scholar]
  14. McLean M. J., Foster W. D., Zimmerman L. E. Prognostic factors in small malignant melanomas of choroid and ciliary body. Arch Ophthalmol. 1977 Jan;95(1):48–58. doi: 10.1001/archopht.1977.04450010050004. [DOI] [PubMed] [Google Scholar]
  15. WESTERVELD-BRANDON E. R., ZEEMAN W. P. The prognosis of melanoblastomata of the choroid. Ophthalmologica. 1957 Jul;134(1):20–29. doi: 10.1159/000303178. [DOI] [PubMed] [Google Scholar]
  16. Zimmerman L. E. Changing concepts concerning the malignancy of ocular tumors. Arch Ophthalmol. 1967 Aug;78(2):166–173. doi: 10.1001/archopht.1967.00980030168009. [DOI] [PubMed] [Google Scholar]
  17. Zimmerman L. E., McLean I. W. Montgomery Lecture, 1975. Changing concepts of the prognosis and management of small malignant melanomas of the choroid. Trans Ophthalmol Soc U K. 1975;95(4):487–494. [PubMed] [Google Scholar]

Articles from The British Journal of Ophthalmology are provided here courtesy of BMJ Publishing Group

RESOURCES