Uveal melanoma: the value of molecular genetic testing for early detection of metastatic disease. Clinical case

Author:

Yarovaya V. А.1ORCID,Golanov А. V.2ORCID,Nazarova V. V.3ORCID,Zaretskii А. R.4ORCID,Levashov I. А.1ORCID,Kulagina А. К.1ORCID,Melnikova Т. V.4ORCID,Matyaeva А. D.1ORCID,Yarovoy А. А.1ORCID

Affiliation:

1. S. Fyodorov Eye Microsurgery Federal State Institution, Ministry of Health of the Russia

2. N. N. Burdenko National Scientific and Practical Center for Neurosurgery, Ministry of Health of the Russia

3. N. N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

4. N. I. Pirogov Russian National Research Medical University, Ministry of Health of Russia

Abstract

To date, the issue of not only timely diagnosis and treatment of patients with uveal melanoma (UM), but also the prediction of this pathology remains relevant. The technology of fine needle aspiration biopsy (FNAB) makes it possible to assess the risk of developing metastatic disease using tumor specimen in patients undergoing organ-preserving treatment by cytological and molecular genetic testing in the primary intraocular lesion. Here we present a case of newly identified locally advanced (T3a) UM, outline the possibilities of organ-preserving treatment using Gamma Knife stereotactic radiosurgery, and also demonstrate the feasibility of conducting a comprehensive prognostic testing on FNAB material, including cytological and molecular genetic and morphological prognostic factors. The results of this testing have made it possible to recommend a more frequent surveillance monitoring regime for metastatic disease, which ultimately led to the early detection of UM liver metastases, followed by their successful treatment.

Publisher

Russian Society of Clinical Oncology

Reference18 articles.

1. Yarovoy A.A., Golanov A.V., Ilyalov S.R., et al. «Gamma-knife» stereotactic radiosurgery for large uveal melanoma as an alternative for enucleation (First results). Ophthalmic surgery 2014;2:74–80. (In Russ).

2. Яровой А.А., Демидов Л.В., Зарецкий А.Р., Яровая В.А., Назарова В.В., Чудакова Л.В. и др. Способ определения тактики ведения пациентов с увеальной меланомой: Патент № 2019136524. 2019

3. Singh A.D., Bergman L., Seregard S. Uveal melanoma: epidemiologic aspects. Ophthalmol Clin North Am 2005;18(1):75– 84. https://doi.org/10.1016/j.ohc.2004.07.002

4. Damato E.M., Damato B.E. Detection and time to treatment of uveal melanoma in the United Kingdom: an evaluation of 2384 patients. Ophthalmology 2012;119(8):1582–9. https://doi.org/10.1016/j.ophtha.2012.01.048

5. Yarovoy A.A., Malyugin E.B., Yarovaya V.A., et al. A fine needle aspiration biopsy of intraocular tumors. Ophthalmic surgery 2020;1:51–56. (In Russ.). https://doi.org/10.25276/0235-4160-2020-1-51-56.

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