Melanoma

Treatment of Ocular Melanoma

Mayo Clinic offers the latest genetic testing (monosomy 3) and treatment options for ocular melanoma. These tumors develop when the eye's pigment-producing cells give rise to cancerous cells. Tumors in the eyes are more resistant to treatment than melanomas on the skin. Identifying and treating ocular melanoma as early as possible is essential.

The primary treatment for ocular melanoma is surgical removal (excision) of the tumor. In rare instances, chemotherapy may be used. The treatment of choice for uveal melanoma, the most common form of ocular melanoma, depends on the tumor size. Treatment options include:

Surgery

Large uveal tumors are generally managed by removing the eye (enucleation). Localized tumor removal surgery also may be used to remove cancerous eye tissue.

Radioreductive surgery

Radioreductive surgery is a procedure developed by specialists at Mayo Clinic in Minnesota to help treat large choroidal melanomas, a type of uveal melanoma. The surgery may eliminate the need for enucleation and allow patients to undergo fewer radiation therapy treatments.

If the tumor is located in the front portion of the eye, a special laser is used during surgery to remove part of the tumor bulk. If the tumor is located in the back of the eye, the patient first receives photodynamic therapy, followed by radioreductive surgery.

Observation

Doctors sometimes observe small uveal melanomas for evidence of further growth before recommending treatment.

Laser therapy

Small uveal melanomas may be treated with laser therapy techniques such as transpupillary thermotherapy and photocoagulation. Laser therapy is often used in combination with other treatments, such as radiation therapy or cryotherapy (cell freezing).

Radiation therapy

Mayo Clinic offers several types of radiation therapy, also known as radiotherapy, to treat ocular melanoma, including an advanced technique called intraoperative ultrasonic plaque localization. This technique allows adequate radiation doses to be precisely delivered to the tumor.

Medium-size uveal melanomas are often treated with plaque therapy, a form of radiotherapy that uses radioactive seeds. Eye surgeons place the seeds in a small tablet that looks like a bottle cap, and sew it on the wall of the eye directly over the tumor. The tablet remains in place for several days before it is removed.

Stereotactic radiosurgery also may be used to treat ocular melanoma.