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Ciliary body melanoma

 

?Ciliary body melanomas account for less than 10% of all uveal melanomas.

 

ciliary-body-melanoma3

Ciliary body melanoma silhouetted against the red reflex

 

Clinical features

  • Dilated blood vessels in the overlying episclera ('sentinel vessels')
  • Visible tumour behind the pupil
  • Secondary retinal detachment
  • Lens complications, such as indentation, astigmatism, subluxation and cataract
  • Secondary glaucoma, from angle involvement by tumour or melanomacrophages or as a result of neovascularisation.
sentinel-vessels-over-a_ciliary-body-melanoma

Sentinel vessels overlying a ciliary body melanoma. The tumour is indenting the lens, which is cataractous, and invading the anterior chamber

 

ciliary-body-melanoma-invading-ant-chamber

Ciliary body melanoma invading anterior chamber, where it is visible as an amelanotic tumour

 

Spread

  • Circumferentially within the ciliary body to form a 'ring tumour'
  • Anteriorly, into anterior chamber, becoming visible on slit-lamp examination
  • Posteriorly, into choroid
  • Extraocularly, to form a sub-conjunctival, pigmented nodule or an area of diffuse pigmentation.

 

Treatments