American joint committee on cancer staging of uveal melanoma
A 55-year-old White male noticed a pigmented spot on the iris left eye (OS). Examination revealed visual acuity of 20/20 in the right eye (OD) and 20/50 OS. Intraocular pressures were 18 mmHg OD and 15 mmHg OS. There was no ocular melanocytosis. The right eye was unremarkable.\nThe anterior segment OS revealed dilated episcleral sentinel vessels superotemporally leading to a brown iris tumor []. The tumor originated in the ciliary body with extension into the iris and with no extrascleral component. There was minor tumor seeding into the anterior chamber angle. The tumor measured 14 mm in diameter and 10.3 mm in thickness by ultrasonography. The final diagnosis was ciliochoroidal melanoma with secondary iris invasion and the tumor was classified according to the AJCC as a T3b N0 M0 with an anatomic stage IIIA and histologic grade GX. The patient was treated with an 18 mm custom-designed round I-125 radioactive plaque with an apex dose of 7000 cGy. Fine needle aspiration biopsy was performed at the time of plaque placement for cytogenetic testing.