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Clinical courses of 2 cases of uveal melanoma with vortex vein invasion Akiko Anraku 1 , Jun Ominato 1 , Naoya Shiozaki 1 , Hiroyuki Cho 1 , Takeo Fukuchi 1 , Riuko Ohashi 2,3 , Yusuke Tani 3 1Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University 2Histopathology Core Facility, Faculty of Medicine, Niigata University 3Division of Molecular and Diagnostic Pathology, Graduate School of Medical and Dental Sciences, Niigata University pp.1279-1285
Published Date 2022/9/15
DOI https://doi.org/10.11477/mf.1410214506
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Abstract Purpose:We report two cases of uveal melanoma associated with vortex vein invasion.

Case 1:A 67-year-old woman presented to our hospital diagnosed with a right intraocular tumor. Evaluation showed a black mass(12 mm in height)near the right ciliary body. She was clinically diagnosed with uveal melanoma and underwent enucleation 20 days after the first visit. Histopathological evaluation confirmed diagnosis of uveal melanoma with vortex vein invasion. Local recurrence occurred beneath the conjunctiva, 7 months after enucleation. We performed surgical resection followed by post-treatment interferon-β(IFN-β)conjunctival injection. The patient developed liver metastasis 9 months after enucleation and underwent transcatheter arterial chemoembolization and immune checkpoint inhibitor(ICI)therapy. However, she died 7 months after diagnosis of liver metastasis.

Case 2:A 69-year-old woman presented to our hospital diagnosed with a right intraocular tumor. Evaluation showed a black mass(8.5 mm in height)at the right eye fundus. She was clinically diagnosed with uveal melanoma and underwent enucleation 13 days after the first visit. Intraoperatively, we observed blackened blood vessels, with suspected invasion of vortex veins. Histopathological evaluation confirmed diagnosis of uveal melanoma without venous invasion;however, vortex invasion was strongly suspected in clinical course. She was administered post-treatment IFN-β conjunctival injection. The patient developed multiple liver metastases 12 months after enucleation and was treated with ICI therapy;however, she died 12 months after the diagnosis of liver metastasis.

Conclusion:Uveal melanoma accompanied by vortex vein invasion is associated with a high risk of local recurrence and liver metastasis;thus establishing an optimal postoperative therapeutic regimen in such cases is important.


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