By M.J. Jager, L. Desjardins, T. Kivelä, B.E. Damato, F. Bandello
Uveal cancer is an competitive kind of melanoma which may contain the iris, the ciliary physique, and/or the choroid, that is the most position of this tumor. sufferers frequently desire to learn approximately therapy offerings and the result of assorted methods. very important present medical questions are no matter if a biopsy might be taken of choroidal melanomas, what might be performed with this biopsy, and no matter if high-risk sufferers will be screened frequently. This quantity describes the scientific features of uveal cancer besides the several present strategies on hand for remedy, similar to radioactive plaque remedy, proton beam remedy, and native tumor resection. additionally, suggestions for taking biopsies and characterizing biopsy fabric are validated. destiny cures reminiscent of anti-VEGF remedy and strategies for the remedy of metastases also are mentioned. citizens with an curiosity in ocular oncology, ophthalmologists or physicians facing uveal cancer, in addition to sufferers wishing to understand extra approximately this malignancy will discover a topical replace on uveal cancer during this booklet.
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Extra resources for Current Concepts in Uveal Melanoma (Developments in Ophthalmology)
I prefer to adopt a wait-and-see approach, with the possibility of performing an autograft of limbal stem cells from the fellow eye, although so far this has not been necessary. Patients are informed that experience with proton beam radiotherapy of extensive iris melanomas is limited so that longterm outcome is uncertain. Others have reported on brachytherapy of iris melanomas using customised plaques . Method of Treatment Selection There is no consensus about how patients should be counselled about the various therapeutic options.
It is useful to remove the lid retractor when putting the most posterior sutures in the sclera to have enough room. In this way, sutures can be placed as far as 22 mm from the limbus. When we put the clips, we try to delineate every side of the tumor (using 4–5 clips, one on each side), but for the most posterior ones, only the anterior sides can be delineated. In this case, usually only 3 clips can be positioned close to the tumor and another clip is put more anteriorly to avoid mistakes in the planning of therapy (this is called the clip for the twist).
The low range of the electrons emitted by the Ru-106 applicators limits the depth of their penetration into the treated tissue. On the other hand, it has the advantage of sparing the surrounding healthy tissue inside and around the eye, and is important for radiation protection of the medical personnel who handle the applicator, and only minor safety precautions have to be undertaken. Reprocessing prior to usage can be easily performed in an autoclave using the dedicated sterilization container.