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Two Distinct Uveal Melanomas in the Same Eye

Ebba J. Nissen, MD1; Helen Kalirai, PhD1; Bertil Damato, MD, PhD2; Heinrich Heimann, MD, FRCOphth3; Sarah E. Coupland, MBBS, PhD, FRCPath1
[+] Author Affiliations
1Liverpool Ocular Oncology Research Group, Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Liverpool, England
2Ocular Oncology Service, University of California, San Francisco
3Liverpool Ocular Oncology Centre, Liverpool, England
JAMA Ophthalmol. 2015;133(9):1094-1096. doi:10.1001/jamaophthalmol.2015.1962.
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This case report describes separate uveal melanomas in the same eye.

Multiple uveal melanomas (UMs) in the same eye with genetic analysis of each tumor are rarely reported.1 We present a case of 2 distinct UMs with differing molecular alterations in the same eye.

Article InformationCorresponding Author: Sarah E. Coupland, MBBS, PhD, FRCPath, Department of Molecular and Clinical Cancer Medicine, Institute of Translational Medicine, University of Liverpool, Daulby Street, Sixth Floor, Duncan Bldg, Liverpool L69 3GA, England (s.e.coupland@liverpool.ac.uk).

Published Online: June 25, 2015. doi:10.1001/jamaophthalmol.2015.1962.

Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.

Additional Contributions: Sophie Thornton, BSc, Liverpool John Moores University, Liverpool, England, provided technical assistance with this case, in particular, the multiplex ligation-dependent probe amplification analyses and the organization of the GNAQ/11 sequencing; she did not receive compensation for these contributions.

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Figure 1.
Ophthalmoscopic Image and Histology of 2 Distinct Uveal Melanomas (UMs)

A, Ophthalmoscopic image of the left eye demonstrating 2 distinct UMs. Line indicates the line of histological sectioning of the globe. B, Enucleation specimen showing 2 UMs (hematoxylin-eosin, original magnification ×1.5). C, The central UM stained with hematoxylin-eosin (original magnification ×10). Inset, Magnified view of the area in the rectangle in C (hematoxylin-eosin, original magnification ×20). D-F, The central UM was positive for Melan A (D), BRCA1-associated protein-1 (E), and heat shock protein 27 (F) (original magnification ×40). G, The peripheral UM stained with hematoxylin-eosin (original magnification ×20). H-J, The peripheral UM was positive for Melan A (H), BRCA1-associated protein-1 (I), and heat shock protein 27 (J) (original magnification ×40).

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Figure 2.
Multiplex Ligation-Dependent Probe Amplification of the Central and Peripheral Uveal Melanomas

Box defines the dosage quotient range for normal diploid copy number. Values above the box indicate gene amplifications; values below, deletions.

aDeletions on chromosome 3.

bGains on chromosomes 6 and 8.

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