Uveal Melanoma Metastatic to the Cavernous Sinus: A Case Report.

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2020-07-21

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Abstract

A woman in her early 50s previously treated 7 years prior with iodine-125 plaque brachytherapy without a biopsy for gene expression profiling for uveal melanoma in the left eye presented with a 3-week history of intermittent diplopia and headache. Ophthalmic examination was significant for limitation in left eye upward gaze; otherwise, examination revealed a stable, regressed tumor in the left eye, and normal vision, pressure, and pupils in both eyes. Neuroimaging showed a left cavernous sinus lesion, suggestive of a meningioma. Excisional biopsy revealed metastatic melanoma. The patient was treated with radiotherapy, and her diplopia resolved. Slight enlargement of the lesion was noted on neuroimaging 20 months later, and was treated with stereotactic radiosurgery. Serial neuroimaging in the following 6 months did not reveal any recurrences or new metastases. This case demonstrates the importance of investigating persistent diplopia in a patient with a history of uveal melanoma, and the possibility of metastases occurring in organs besides the liver or lung.

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10.1097/iop.0000000000001778

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Assi, Lama H, Wajiha J Kheir, Alan D Proia and Miguel Angel Materin (2020). Uveal Melanoma Metastatic to the Cavernous Sinus: A Case Report. Ophthalmic plastic and reconstructive surgery, Publish Ahead of Print. 10.1097/iop.0000000000001778 Retrieved from https://hdl.handle.net/10161/21559.

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Scholars@Duke

Proia

Alan David Proia

Professor of Pathology

My research interests are focused on the pathology and genesis of diseases affecting the eye and adjacent structures.  

Materin

Miguel Angel Materin

Professor of Ophthalmology

Miguel A. Materin, MD serves as Division Chief of Ocular Oncology, Professor of Ophthalmology, Professor of Radiation Oncology at Duke Eye Center. 

His full-time clinical practice involves diagnosis and treatment of patients with ocular tumors. He specializes in ocular melanoma, retinoblastoma, choroidal hemangioma, retinal hemangioblastoma, ocular metastases, astrocytic retinal tumors and tumors related to other conditions or syndromes, such as von Hippel Lindau disease, Tuberous Sclerosis among others. 

Dr. Materin joined Duke in September 2016 from Yale University School of Medicine where he was an Associate Professor of Ophthalmology & Visual Science, and Director of Ophthalmic Oncology at Smilow Cancer Hospital at Yale New Haven.

Prior to his appointment at Yale, he was the Director of Diagnostic Studies and Research Fellows for the Ocular Oncology Service at Wills Eye Hospital at Thomas Jefferson University in Philadelphia, where he completed his fellowship in ocular oncology in 1999.


He is an internationally recognized ocular oncologist who has more than 100 publications in peer-reviewed literature, including journals and book chapters. Dr. Materin has been invited as a visiting professor in the U.S., Canada, Israel, Spain, Brazil, Puerto Rico, Argentina, and has given more than 300 lectures.

Dr. Materin received the Achievement Award and Senior Achievement Award from the American Academy of Ophthalmology. He is a Member of Merit of Clinica Barraquer (Barcelona, Spain) and Colombian Society of Ophthalmology. He is an active member of the International Society of Ocular Oncology, American Academy of Ophthalmology, Pan American Association of Ophthalmology.

Dr. Materin served on the education committee of the American Association of Ocular Oncology and Pathology and is past-President of the Pan American Society of Ocular Oncology. He is a Panel Member of the National Comprehensive Cancer Network for Uveal Melanoma.


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