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Case Reports
. 2011 Jun;249(6):937-40.
doi: 10.1007/s00417-010-1590-8. Epub 2010 Dec 14.

Multifocal Iris Melanoma Treated With Total Anterior Segment palladium-103 Plaque Radiation Therapy

Case Reports

Multifocal Iris Melanoma Treated With Total Anterior Segment palladium-103 Plaque Radiation Therapy

Vasileois Petousis et al. Graefes Arch Clin Exp Ophthalmol. .


Background: A 73-year-old patient presented in our clinic with multiple pigmented iris nodules in the left eye. Though asymptomatic, there was a reported increase in size and number of the nodules during the past year.

Methods: Interventional case report describing a biopsy-proven multifocal iris melanoma treated with a palladium-103 plaque to include the entire anterior chamber within the targeted zone. Biopsy was performed utilizing a 25-gauge aspiration-cutter under viscoelastic. The cornea was protected during radiation therapy with the amniotic membrane buffer technique. Evaluation parameters included visual acuity and clinical assessments aided by slit-lamp photography as well as high-frequency ultrasound imaging.

Results: Plaque radiation therapy was well tolerated. Her visual acuity has remained within five letters at 20/25 at 1-year follow-up. Clinical evaluation revealed no evidence of corneal epitheliopathy, iris neovascularization, or visually significant cataract. High-frequency ultrasound imaging revealed a 15% reduction of the tumor's height. Serial abdominal imaging revealed no metastatic uveal melanoma.

Conclusions: We present a biopsy-proven iris diffuse melanoma treated with palladium-103 plaque radiation therapy. Though the entire anterior segment was irradiated, there were no significant side-effects. Local tumor control was excellent during the first postoperative year.

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