Research Letter |

Extrascleral Spread of Choroidal Melanoma via Tantalum Marker Suture Track

Shilpa J. Desai, MD1; H. Jane Kim, MD1; Robert C. Kersten, MD1; Michele M. Bloomer, MD1; M. Reza Vagefi, MD1
[+] Author Affiliations
1Department of Ophthalmology, University of California, San Francisco
JAMA Ophthalmol. 2013;131(12):1643-1645. doi:10.1001/jamaophthalmol.2013.5042.
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Proton beam irradiation allows globe-sparing treatment of uveal melanoma with excellent local control rates.1 Recurrence after radiotherapy is low, ranging from 2% to 5%. Treatment first requires delineation of the tumor by placement of tantalum markers that are sutured to the sclera.2 We report a case of multifocal, extrascleral spread of choroidal melanoma along the suture track of a tantalum marker after proton beam therapy.

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Figure 1.
Clinical Photograph

A 65-year-old woman presented with multifocal, extrasceral spread of choroidal melanoma in the right eye 17 months after proton beam therapy. Multiple pigmented, subconjunctival lesions of the nasal globe are noted.

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Figure 2.
Histopathologic Sections of the Exenteration Specimen

A, Primary posterior necrotic tumor with overlying tantalum marker suture (hematoxylin-eosin, original magnification ×10). Inset, Melanoma cells seen around the suture material (hematoxylin-eosin, original magnification ×40). B, Posterior extrascleral extension of the tumor (hematoxylin-eosin, original magnification ×2). Inset, Melanoma cells along the suture material (hematoxylin-eosin, original magnification ×20).

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