Origin |
Melanocytes located in the basal layer of the epidermis of the skin |
Uveal - melanocytes situated in the stroma of the uveal layer of the eye |
Conjunctival - melanocytes situated in the basal layer of the conjunctiva |
Rate per million [1] |
153.5 |
6 all ocular melanomas |
4.9 uveal melanoma |
0.4 conjuctival melanoma |
Male vs. female rate per million [1] |
193.7 vs. 125.2 |
6.8 vs. 5.3 for all ocular melanomas |
5.7 vs. 4.4 for uveal melanomas |
0.4 both genders for conjunctival melanoma |
Trends in incidence |
Rising [81,117] |
Uveal melanoma - stable [6] |
Conjunctival melanoma - rising [7,76,80] |
Role of a UV light as risk factor |
Well supported [118] |
Still uncertain |
Mean age |
55.3 years [119] |
Uveal melanoma - 58 years [8] |
Conjunctival melanoma - 57.4 years [77] |
White:black ratio |
16:1 [1] |
8-10:1 for all ocular melanomas [1] |
2.6:1 for conjunctival melanoma [5] |
Metastasizing |
Lymphogenous and hematogenous |
Uveal - hematogenous |
Conjunctival - lymphogenous and hematogenous |
Most common sites of metastases |
skin (13–38%) |
Uveal |
distant lymph nodes (5–34%) |
Liver (93%) |
distant subcutaneous tissues (32%) |
Lung (24%) |
lung (18–36%) |
Bones (16%) [45] |
liver (14–20%) |
Conjunctival |
CNS (2–20%) |
Lymph nodes (cervical, preauricular, parotid and submandibular) |
bone (4–17%) [120] |
Lungs, liver, skin and brain [75,77,88] |
Five-year survival |
80.8% [119] |
81.6% - uveal melanoma [6] |
86.3% - conjunctival melanoma [77] |
Treatment |
91.5% surgery only [119] |
Uveal - 28.3% surgery only 62.5% radiotherapy only [6] |
Conjunctival - nowadays mostly surgical excision combined with adjuvant therapy |
Common genetic mutations |
BRAF |
GNAQ and GNA11 - uveal melanoma [102,103] |
CDKN2A |
BAP1 - metastasizing uveal melanoma [110] |
NRAS [121] |
BRAF - iris and conjunctival melanoma [107,108] |