Ciliary body melanoma is one of the rarest subtypes of uveal melanoma, the other respective locations being the iris and the choroid. The clinical presentation is frequently absent in the initial stages and the tumor is often recognized when metastatic spread has already occurred. A dilated fundus examination can be sufficient to make a presumptive diagnosis, but more advanced studies, such as slit-lamp examination, optical coherence tomography (OCT), and ultrasound biomicroscopy, are pivotal in order to confirm this neoplasm.
Established as the most common primary neoplastic disease of the eye in the Caucasian adults, uveal melanoma can arise from three main locations - the choroid, the iris, or the ciliary body   . Ciliary body melanoma (CBM), according to certain reports, is responsible for about 6-15% of all uveal melanomas and is often described as an extension of choroidal or iris melanoma  . Despite the fact that ocular symptoms have been reported with this type of tumor (a wide, dilated pupil, lens displacement causing accommodation difficulties and/or increased intraocular pressure that manifests as blurred vision, visual field loss that may or may not be accompanied by pain if glaucoma develops), one of the main features of CBM is a very late diagnosis   . An extremely small diameter of the tumor and it's insidious onset are one of the main reasons why patients are predominantly recognized in the advanced stages when metastases are present, with symptoms of weight loss, cough, fatigue and other organ-related signs . Metastases are recognized after 3 years in 12% of patients, whereas up to a third of cases have CBM after 10 years  . The mean age at presentation is between 55-62 years  .
His past medical history included prostate cancer that had remained untreated due to low prostatic-specific antigen levels and inactivity, as well as non–insulin-dependent diabetes and hypertension. [retinalphysician.com]
Anterior Chamber Brain and Optical Pathway Choroid Congenital Syndromes, Malformations and Abnomalities Conjunctiva Cornea Glaucomas, Ocular Hypertension Hypertensive Retinopathy Iris and Ciliary Body Lacrimal System Lens Lids Neuro-Ophthalmology Optic [atlasophthalmology.net]
The diagnosis of CBM is difficult to make, which is why a thorough clinical examination is an essential component of the workup. After a detailed history that will assess the presence of symptoms, as well as their onset and duration, the physical examination should encompass a fundus exam (with a dilated pupil) that reveals a dome-shaped pigmented mass which may extend to the iris or to the posterior segments of the eye  . However, the need for more advanced imaging studies, particularly because of the small tumor diameter and location (CBMs can be often hidden behind the iris) is often required - ultrasound biomicroscopy, optical coherence tomography, transillumination, and fundus fluorescein angiography (FFA) have all been recommended by various studies in order to determine the exact size and location of the tumor     . OCT or magnetic resonance imaging (MRI) are also useful in the assessment of ciliary body melanoma  , but to confirm the diagnosis, a histopathological examination must be performed. A fine-needle aspiration biopsy (FNAB) is the recommended procedure that allows a viable sample to be obtained for testing  .
Using this information, patients at high risk for neovascular glaucoma could be considered for prophylactic treatment with panretinal photocoagulation. [ncbi.nlm.nih.gov]
Disease Medulloepithelioma Etiology Medulloepithelioma is a tumor that arises from the epithelium of the medullary tube, most often the ciliary body. [atlasgeneticsoncology.org]
Etiology Primary ciliary body melanoma arises from melanocytes in the uveal tract. Although uveal melanomas may grow de novo, most develop from a preexisting melanocytic nevus. [emedicine.medscape.com]
(Etiology) The exact cause of Ocular Melanoma is unknown. No direct linkage between sun-exposure and Ocular Melanoma has been established. [dovemed.com]
The etiology of uveal melanoma is not entirely clear. The disease is most commonly diagnosed in people with light eyes that are under prolonged exposure to UV-radiation. [eurjmedres.biomedcentral.com]
Melanomas of the eye and other noncutaneous sites: epidemiologic aspects. [ncbi.nlm.nih.gov]
Epidemiology Choroidal melanomas are found most often in countries with large populations of people of northern European decent. [atlasgeneticsoncology.org]
Epidemiology Conjunctival melanomas account for less than 5-10% of all ocular melanomas. They usual present in adulthood . There is no sex preponderance. [mmmp.org]
Diagnosis: Ciliochoroidal malignant melanoma EPIDEMIOLOGY Most common primary intraocular malignancy in adults Incidence: In US, 6-7 cases per million (Shields 1992) Age: rare in children, primarily affects patients in 50s and early 60s Sex : men (55% [webeye.ophth.uiowa.edu]
Predisposing conditions for uveal melanoma include the following: Uveal nevus Congenital ocular melanocytosis Dysplastic nevus syndrome Family history of uveal melanoma Epidemiology Incidence in the United States The incidence of primary intraocular melanoma [emedicine.medscape.com]
Comprehensively updated to reflect everything you need to know regarding retinal diagnosis, treatment, development, structure, function, and pathophysiology, this monumental ophthalmology reference work equips you with expert answers to virtually any [books.google.com]
Pathophysiology Melanoma in the ciliary body poses a serious threat to life. It usually remains hidden behind the iris diaphragm, growing undetected for longer periods of time than melanoma in the iris or choroid. [emedicine.medscape.com]
Prevention - Melanoma of the ciliary body Not supplied. Diagnosis - Melanoma of the ciliary body Ciliary body melanoma patients may present with a new astigmatism that is difficult to refract. [checkorphan.org]
Does enucleation of the eye containing a melanoma prevent or accelerate the dissemination of tumour cells? Br. J. Ophthalmol. 62: 420–425 (1978). Google Scholar Copyright information Dr W. Junk Publishers 1985 Authors and Affiliations W. R. Lee 1 J. [link.springer.com]
Limiting excessive ocular sunlight exposure through sunglasses or other means may, theoretically, have a preventive effect in patients with predisposition to intraocular melanoma. [emedicine.medscape.com]
Survival rates in cases of uveal melanoma and retinoblastoma the leading intraocular malignancies in adults and children may be high, but means of earlier diagnosis and improved treatment options are needed to preserve vision and prevent metastasis This [distinctgifts.co.uk]
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