Where Does Ocular Melanoma Metastasize To & How Long Does It Take For Melanoma To Metastasis?

Uveal melanoma is the most widespread acute eye cancer in people with white skin and signifies 75% of all primary ocular cancers. In patients with metastatic uveal melanoma, the prognosis for those with initial metastasis to the liver is particularly poor. The standard survival of patients who initially develop liver metastasis from uveal melanoma is 4 to 6 months, as contrasted with 16 months for other initial sites of metastasis.

A small fraction of individuals will acquire metastases even at the later stage after their initial symptoms. Metastatic disease is commonly lethal. Nevertheless, enhanced knowledge of the molecular inheritances and intracellular signaling of uveal cancer has resulted in the advancement of immunotherapy and targeted systemic treatments.

Where Does Ocular Melanoma Metastasize To?

Where Does Ocular Melanoma Metastasize To?

If you are recently identified with a leading choroidal ocular melanoma, you tend to have no symptoms of metastatic melanoma. Even with total-body PET/CT imaging, less than 4% of patients are found to have their melanomas spread to other parts of their body at the time of diagnosis of their eye tumor.

However, there is an increased risk to have metastasis in the upcoming years. This is due to the fact there is no examination to determine microscopic metastatic melanomas. Fortunately, most of the infected patients were identified during the onset of a choroidal tumor before they developed a metastatic tumor.

Another primary risk of metastatic melanoma is often co-related to the size of the tumor. Apparently, there are treatments that have the ability to control the progression of the tumor size thereby limiting the probability of metastasizing. This is one of the key factors why most ophthalmology oncologist or eye specialist consider eliminating or destroying the malignancy is the preferred method to avoid further spread of cancer.1,2

The histological and immunohistochemical findings in metastatic uveal melanoma to the liver are evaluated. This is done by performing an autopsy on the samples of the liver from patients who died due to metastatic uveal cancer. The study showed that uveal cancer can be identified as

  • Stage 1 when they spread to the liver and the tumor size is approximately ≤50 μm in diameter
  • Stage 2 when the tumor size grows larger and is in the range between 51–500 μm in diameter
  • Stage 3 when the condition is in the most advanced stage and the tumor size >500 μm in diameter

During this advancement, cancers become vascularized and mitotically functional.3,4

How Much Time Does It Take For Melanoma To Metastasis?

Uveal melanoma represents nearly 80% of all eye cancer and approximately 40% of patients ensue metastatic tumors. Metastases are often confined to the liver and, a small number of patients undergo a theoretically curative operation, this is linked with a poor diagnosis.

In the Collaborative Ocular Melanoma Study (COMS) the liver was the most common site with several patients diagnosed with metastasis with increased mortality rate following the statement of tumor metastasis was 80% at 12 months and 90% at 24 months

There is presently little available data for the optimum management and treatment of metastatic uveal malignancy and the lack of efficient treatments in this scenario has directed to the common use of systemic therapies for patients with cutaneous tumors.

A rare case of a patient of choroidal tumor left eye who acquired very early liver metastasis within just 7 months even after primary therapy completion of leading cancer comprises of enucleation and 3-dimensional conformal radiation treatment. Hence, metastasis should be intensely sought following the treatment of a primary lesion.5,6

References:

  1. Living With OM – Ocular Melanoma Foundation http://www.ocularmelanoma.org/living-with-om.htm
  2. Metastatic Choroidal Melanoma – New York Eye Cancer Centre https://eyecancer.com/eye-cancer/conditions/metastatic-ocular-tumors/metastatic-choroidal-melanoma/
  3. Metastatic disease from uveal melanoma: treatment options and future prospects https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5256122/
  4. How Dangerous is Melanoma? It’s All a Matter of Timing https://www.skincancer.org/blog/dangerous-melanoma-matter-timing/
  5. What Do the Symptoms of Stage 4 Melanoma Look Like? https://www.healthline.com/health/cancer/stage-4-melanoma-pictures
  6. If melanoma skin cancer spreads – Canadian Cancer Society https://www.cancer.ca/en/cancer-information/cancer-type/skin-melanoma/if-cancer-spreads/?region=on

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