Symptoms and treatment of ocular melanoma
Melanoma (melanoblastoma) refers to malignant tumors that form in the place of pigment cells (melanocytes) producing melanin. The most likely place of localization of pathology is the skin, less often mucous membranes are affected (retina, mouth, vagina, anus). Melanoma is considered one of the most dangerous malignant tumors.
Melanoma of the eye is the most common primary tumor of the eye, which is accompanied primarily by a sharp drop in vision. Small-sized melanoma is often mistaken for a pigmented spot in the eye area when viewed. According to statistics, this pathology manifests itself in 5-7% of all cases of pathologies in humans of a pigmented nature with a malignant course.
Symptoms of eye melanoma
Melanoma of the eye is subdivided into melanoma of the conjunctiva, eyelid, vascular or ciliated body, iris. Melanoma of the century, which is quite rare, has the highest degree of malignancy and, therefore, belongs to the most dangerous pathologies, it belongs to subcutaneous and skin formations.
Melanoma in the conjunctival region of the eye is rare in patients. It is formed in most cases at the site of age spots and can appear in both the elderly and young people. The formation can eventually move to the eyelid, affect the cornea, the orbit of the eye, which can be dangerous. Melanomas of the conjunctiva develop very quickly, in some cases rapidly reaching large sizes. They can also affect the cornea, sclera and orbit of the eyeball.
Intraocular melanomas, or melanomas in the region of the choroid, are located in most cases in their own choroid (85% of cases). However, in 9% of patients, such a formation occurs in the ciliary body, and in 6% of cases - in the iris. Recently, among various eye pathologies, the number of patients with just such a diagnosis has increased. In this case, the size of the tumor can be up to 15 mm.
There are two forms of development of choroidal melanoma: nodular (the most common) and diffuse, or planar. From a morphological point of view, four types of tumors are distinguished: spindle cell, fascicular, epithelioid and mixed. The most malignant of them is epithelioid melanoma, and the melanoma with the most favorable prognosis is spindle cell.
In most cases, it is not possible to detect the type of melanoma grossly. It is important to discern characteristic changes in a timely manner. The main symptoms of melanoma are: a drop in vision, discomfort in the eye area, a change in its color, the appearance of ulceration, an increase in the size of the eye, accompanied by swelling under the eyelid, bleeding in the affected area, the formation of nodes.
Eye melanoma treatment
The therapy is carried out after a thorough examination and diagnosis. Today, several methods of treating ocular melanoma are used in practice. The most common and effective of them is surgery, which is accompanied by complete removal of the tumor. The excision is carried out together with the adjacent areas of healthy tissue. Simultaneously with melanoma, the entire subcutaneous tissue is cut out to the fascia of the muscle located below. The need for excision of the fascia is considered a controversial issue and is not carried out by many specialists. Positive lymph nodes are also subject to resection.
Surgical intervention can also be performed using a microscope, which is used to improve the quality of measures to control the course of the operation, to increase its efficiency.
In the treatment of the disease, immunotherapy with interferon alfa-2b, radiation therapy, photodynamic, systemic chemotherapy, cryo- and laser destruction are also used.
Treatment of melanoma of the eyelid in most cases is combined. It implies radiation therapy and surgery itself.
Therapy for conjunctival melanomas also requires an integrated approach, or rather partial or complete removal of the eyeball or excision of the entire orbit, after which the patient needs a course of radiation therapy.
Modern doctors try, whenever possible, to apply organ-preserving methods of treatment. There is evidence that surgical intervention, accompanied by loss of vision, does not give a favorable prognosis.
Experts note that with melanoma in the conjunctival region and on the skin of the eyelids, it is more effective and safer to use non-surgical methods of treatment, such as cryodestruction. This technique allows you to maintain visual functions without significant changes.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".
