CAVITARY MELANOMA OF THE CILIARY BODY - A STUDY OF 8 CASES

Purpose: The authors present the unique clinical features of cavitary uveal melanoma. Design: Retrospective chart review. Participants: Eigh t patients with cavitary uveal melanoma. Main Outcome Measures: The cl inical, ultrasonographic, and histopathologic features of eight patien ts with cavitary melanoma of the ciliary body were studied. Results: I n all eyes there was a brown ciliary body mass that blocked transmissi on;of light on trans-scleral transillumination. Ocular ultrasonography revealed a large, single hollow cavity (unilocular ''pseudocyst'') in five cases and multiple hollow cavities (multilocular ''pseudocyst'') in three cases. The cavity occupied a mean of 55% of the entire mass thickness (range, 31%-79%). In five cases, a basal uveal mass was note d on ultrasonography. Four patients underwent tumor resection; one had enucleation, and three had I-125 radioactive plaque treatment. In the five cases confirmed histopathologically, the cavitation was empty, c ontained erythrocytes, serous fluid, and/or pigment-laden macrophages. In no case was the cavity lined by necrotic tumor, endothelial cells, or epithelial cells. Conclusion: Ciliary body melanoma can develop an intralesional cavity resembling an intraocular cyst. The presence of a solid mass at the base and a thick wall surrounding the cavity can a ssist in the differentiation of cavitary melanoma from benign cyst.