This 66YO female underwent plaque radiotherapy for a uveal malignant melanoma (MM) seventeen years earlier in 2007. The tumor responded well to this single treatment, and she has been followed twice yearly since. On 12/16/24, she had no new symptoms, and vision was stable at counting-fingers.
When examined about 8 months earlier, on 3/13/24, the tumor was stable compared with the prior Optos color RG image from 12/16/20. On the 12/26/24 visit, there is marked tumor growth with apparent optic nerve involvement/
Metastatic workup, including brain MRI and CT of the chest, abdomen, and pelvis, showed no metastases. She was referred to ocular oncology for further management.
Learning Points:
It is extremely rare for a previously dormant tumor to recur so many years following initially successful treatment. The Collaborative Ocular Melanoma Study (COMS) found that local treatment failure occurred in 10% of eyes, most commonly within 3 years of treatment (Jampol et al, Ophthalmology 2002;109:2197-2206). Our case highlights the need for continued long-term monitoring of these patients.
