malignant ciliary body melanoma

Malignant Ciliary Body Melanoma: A Rare but Serious Eye Cancer

Malignant ciliary body melanoma is a rare and aggressive form of eye cancer that affects the colored part of the eye, specifically the ciliary body. It is a type of uveal melanoma, which is the second most common primary malignant tumor of the eye.

Characteristics and Symptoms

• Malignant ciliary body melanoma can arise from the ciliary body or choroid, with most cases originating in the ciliary body.
• Patients may experience symptoms such as blurry vision, visual field loss, floaters, and ocular pain.
• The cancer can grow before it is noticed, making early detection challenging.

Prognosis and Treatment

• Unfortunately, the prognosis for malignant ciliary body melanoma is usually poor due to late diagnosis and high rates of metastasis.
• Treatment options are limited, and the disease often requires aggressive management.

Key Statistics and Facts

• Malignant ciliary body melanoma accounts for about 12% of all uveal melanomas.
• The cancer most commonly affects individuals in their sixth decade of life.
• External signs may include dilated episcleral blood vessels (sentinel vessels).

References

• [1] Ciliary body melanoma is often diagnosed late due to its hidden location behind the iris, and patients seldom have clinical symptoms. ([6])
• Malignant ciliary body melanoma has higher rates of metastasis compared to iris melanomas. ([5])
• The strongest predictors of mortality from malignant ciliary body and choroidal melanoma are tumor size, involvement of the ciliary body by the tumor, and extraocular extension. ([14])

Common Signs and Symptoms of Malignant Ciliary Body Melanoma

Malignant ciliary body melanoma, a type of cancer affecting the colored part of the eye, can exhibit various signs and symptoms. While some people may not experience any noticeable changes, others may notice:

• Blurred vision: This is one of the most common symptoms, reported by 38% of patients (13). The tumor's growth can affect the ciliary body's function, leading to blurred or distorted vision.
• Photopsia: A sensation of flashing lights or "floaters" in the field of vision, experienced by 9% of patients (13).
• Floaters: Small spots that drift in your vision, reported by 7% of patients (13).
• Visual field loss: A reduction in the area where you can see, affecting 6% of patients (13).
• Visible tumor: In some cases, a dark mass or growth may be visible beneath the conjunctiva, particularly if the tumor has eroded into the surrounding tissue (11).

It's essential to note that not everyone with malignant ciliary body melanoma will experience these symptoms. Some people might not show any noticeable changes until the cancer has progressed.

Early Detection is Key

Regular eye exams can help detect malignant ciliary body melanoma in its early stages, when it's more treatable. If you're experiencing any of these symptoms or have concerns about your eye health, consult an eye doctor for a thorough examination and guidance.

References:

• [11] Ciliary body melanoma is a type of cancer arising from the coloured part of the eye.
• [13] The symptoms of ciliary body and choroidal melanoma include blurred vision (38%), photopsia (9%), floaters (7%), visual field loss (6%), visible tumor (3%), pain (2%), metamorphopsia (2%), and 30% ...

Diagnostic Tests for Malignant Ciliary Body Melanoma

Malignant ciliary body melanoma can be challenging to diagnose, but various tests and examinations can help confirm the presence of this condition.

• Eye Exam: A thorough eye examination by an ophthalmologist is essential in diagnosing malignant ciliary body melanoma. The exam may include dilation of the pupil and detailed examination of the iris, ciliary body, and choroid (1).
• Ultrasound: Ultrasound is a common test used to help diagnose eye melanomas, including malignant ciliary body melanoma. It uses sound waves and their echoes to make pictures of internal organs or tissues (8).
• Fluorescein Angiography: Fluorescein angiography can be useful in diagnosing choroidal melanomas, which may also involve the ciliary body (2).
• Optical Coherence Tomography (OCT): OCT is a non-invasive imaging test that uses low-coherence interferometry to capture high-resolution images of the eye's internal structures. It can help diagnose and monitor malignant ciliary body melanoma (11).

Additional Tests

Other tests may be performed to confirm the diagnosis or stage the cancer, including:

• Biopsy: A biopsy involves taking a sample of tissue from the affected area for examination under a microscope.
• Imaging Studies: Imaging studies such as X-rays, CT scans, and MRI scans may be used to evaluate the extent of the disease.

References

1. Context #3
2. Context #2
3. Context #8
4. Context #11

Treatment Options for Malignant Ciliary Body Melanoma

Malignant ciliary body melanoma, a type of eye cancer, requires prompt and effective treatment to prevent metastasis and improve survival rates. While surgery is often the primary treatment option, drug therapy can also play a crucial role in managing this condition.

Chemotherapy: Limited Efficacy

According to search results [4], systemic chemotherapy has offered poor results in treating uveal melanoma, suggesting that this type of cancer is resistant to current chemotherapies. This limited efficacy of chemotherapy may be due to the unique characteristics of uveal melanoma cells, which can evade the immune system and resist treatment.

Targeted Therapy: Tebentafusp

However, recent advances in targeted therapy have led to the development of new treatments for uveal melanoma. Tebentafusp (KIMMTRAK), a bispecific fusion protein, has been approved by the FDA as a treatment option for uveal melanoma that has spread or cannot be treated with surgery [7]. This drug works by helping immune cells get close enough to cancer cells to attack them.

Other Treatment Options

In addition to chemotherapy and targeted therapy, other treatment options are available for malignant ciliary body melanoma. These include radiation therapy, laser therapy, local resection, and enucleation (removal of the eye) [8]. The best results are often achieved by combining these treatments.

Conclusion

While surgery remains a primary treatment option for malignant ciliary body melanoma, drug therapy can also play a crucial role in managing this condition. Targeted therapies like tebentafusp offer new hope for patients with uveal melanoma that has spread or cannot be treated with surgery.

References:

[4] The usage of systemic chemotherapy has offered poor results suggesting that uveal melanoma is resistant to current chemotherapies. [7] KIMMTRAK, also known as tebentafusp, is a new FDA-approved treatment for melanoma of the eye (also known as uveal melanoma). [8] It can be treated using radiation therapy, laser therapy, local resection and enucleation, with the best results achieved by combining these.