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Uveal Melanoma of the Skin

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Posted by fatima.shakeel@opmc.co | Nov 28, 2024

What is Uveal Melanoma?

Uveal Melanoma is a rare eye cancer that develops in the uvea, which includes the iris (coloured part of the eye), the ciliary body, and the choroid (a blood vessel layer at the back of the eye). Unlike skin melanoma, uveal melanoma occurs inside the eye and has distinct genetic features.

Causes

The exact cause is unknown, but certain genetic mutations, like those in the GNAQ, GNA11, and BAP1 genes, are linked to its development. Unlike skin melanoma, sun exposure is not a significant factor.

Signs and Symptoms

Early-stage uveal melanoma often has no symptoms, but as it grows, it can cause:

  • Blurred or distorted vision
  • Seeing flashes of light or “floaters”
  • A dark spot on the iris
  • Rarely, eye pain
    Sometimes, these vision changes lead to an eye exam where the tumour is detected.

Diagnosis

Diagnosis involves a detailed eye exam and imaging tests, such as an ultrasound or MRI of the eye. A biopsy may be done to confirm the diagnosis and identify the tumour’s genetic characteristics.

Treatment

For localised uveal melanoma, options include:

  • Radiation Therapy: Such as plaque brachytherapy, where a small radioactive device is placed near the tumour to target cancer cells
  • Surgery: Removal of the tumour or, if necessary, the entire eye
    If the cancer spreads (often to the liver), treatment may include:
  • Liver-directed therapies to target cancer cells in the liver
  • Immunotherapy: Drugs like Tebentafusp, specifically for metastatic uveal melanoma, help the immune system fight cancer

Prognosis

Outlook depends on factors like tumour size, location, and genetic mutations. Approximately 40-50% of patients may develop metastases, often in the liver, which can worsen outcomes.


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