The orbital extension in choroid melanoma is treated with
Correct Answer: Exentration
Description: (Exenteration) (165-Khurana) (326-Kanski 5th) (356-P)Malignant melanoma of choroid - It is the most common primary intraocular tumour of adults (40-70 years) of age.TREATMENT1. Conservative treatment using cobalt plaques photocoagulation or cryocoagulation may be tried in small (under 7 mm) non progressive, posteriorly located melanomas.2. Enucleation - It is indication for glaucomatous stage and for longer tumours (more than 7 mm) in quiescent stage3. Exenteration or, Debulking with chemotherapy and radiotherapy is required in the stage of extraocular spread4. Chemotherapy and immunotherapy - may be of some use in patients with distant metastasis.ENUCLEATIONEVISCERATION* It is excision of the eyeball. It can be performed under LA in adults and under GA in children.* It is the removal of the contents of the eyeball leaving behind the sclera* Frill evisceration is preferred over simple evisceration.Indication(i) Absolute indications - are retinoblastoma and malignant melanoma(ii) Relative indications are painful blind eye following absolute glaucoma, endophthalmitis, mutilating ocular injuries, Anterior staphyloma and phthisis bulbiIndications includes Panophthalmitis, expulsive choroidal haemorrhage, bleeding anterior staphyloma.Exenteration of the orbit is indicated for patients with extensive extraocular extension at the time of diagnosis or for orbital recurrences following enucleation (326-Kanski 5th)Best answer is Exenteration & radiotherapy.Orbital spread of the malignant melanoma necessitates exenteration but metastasis elsewhere can be treated by enucleation and radiation (356-P)
Category:
Ophthalmology
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