Metastatic disease of melanoma malignum choroid

Abstract

Introduction. Choroidal melanoma is a rare form of cancer, with a total of 3-5% of the patients suffering from this type of disease. People who are more likely to suffer from the disease are of the white race, bright skin color and iris, as well as those with a genetic mutation BAP 1 and GNAQ. Studies indicate the micro-metastatic disease before the primary process is diagnosed. There is no effective therapy to prevent the development of metastases. In 90% of cases the metastases are in the liver. Metastases can occur any time after the diagnosis of melanoma, even after 40 years. The prognosis of metastatic disease is bad, the median of survival per year is 4 to 15 months. Case report. The patient had enucleation of the eye, when he was primarily treated for malignant melanoma of choroid in 2007. He also appeared regularly for checkups. Felt healthy. 9 years later, dizziness and instability occurred. After a seizure, on July 2016, echotomography and computed tomography diagnosed liver, brain metastases as well as changes in the right lung. Radio-oncology treatment deposits in the brain done with Gama knife, as well as systemic hemotherapy with Dacarbazine. Changes in the lung treated as a secondary deposit. Despite oncology and palliative treatment, the patient passed away 6 months after the diagnosis of the metastatic disease. Conclusion. It is important to point out the importance of early and accurate diagnosis and early treatment of malignant diseases. During the period of monitoring the patient, rare localizations of the metastases must be considered, as well as the possibility of their occurrence long time after the discovery of the primary malignancy. For this case report, the data obtained from extensive medical documentation was used, as well as several years of monitoring patients in Primary care.

Keywords

• melanoma
• choroid
• genetics
• palliative care
• primary health care