Delayed Distant Recurrence of a Uveal Melanoma 4 Decades after Enucleation

Introduction: This report presents a case of an exceptionally delayed distant recurrence of a choroidal melanoma, occurring 4 decades after the enucleation of the affected eye. Case Presentation: In 1977, a 29-year-old man underwent enucleation for a choroidal melanoma. At the age of 68 years, he wa...

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Main Authors: Nils A. Eide, Agate Noer, Henrik Jespersen, Peter Jebsen, Jürgen Geisler
Format: Article
Language:English
Published: Karger Publishers 2024-10-01
Series:Case Reports in Oncology
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Online Access:https://beta.karger.com/Article/FullText/541341
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author Nils A. Eide
Agate Noer
Henrik Jespersen
Peter Jebsen
Jürgen Geisler
author_facet Nils A. Eide
Agate Noer
Henrik Jespersen
Peter Jebsen
Jürgen Geisler
author_sort Nils A. Eide
collection DOAJ
description Introduction: This report presents a case of an exceptionally delayed distant recurrence of a choroidal melanoma, occurring 4 decades after the enucleation of the affected eye. Case Presentation: In 1977, a 29-year-old man underwent enucleation for a choroidal melanoma. At the age of 68 years, he was diagnosed with advanced prostate cancer. Although the metastatic prostate cancer responded to treatment, a persistent lung lesion warranted further examination. A lung biopsy, somewhat surprisingly, confirmed the presence of melanoma metastasis, 4 decades after the enucleation. The cells were positive for Melan-A, while no BRAF mutation was identified. Two years later, new lesions appeared in the liver, and CT showed progression with multiple new sites. A liver biopsy revealed again melanoma recurrence, and its choroidal origin was verified by the presence of a GNA11 mutation. The patient underwent radiation therapy for the lung and liver lesions, followed by immunotherapy. However, the patient died 11 months after the recurrence in the liver. In this case report, the micrometastatic melanoma cells appear to have remained dormant for an extended period, before the patient’s treatment in 1977, but the reason for the late reactivation from the dormant state remains unclear. Conclusion: The recurrence of a choroidal melanoma is substantiated by the histopathological and molecular analyses, including the finding of a GNA11 mutation. This case exemplifies a remarkably delayed distant recurrence of a choroidal melanoma, which manifested clinically 40 years following enucleation.
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spelling doaj-art-a19dd4cddc9242a29fbb4699b7a405032025-08-20T02:12:47ZengKarger PublishersCase Reports in Oncology1662-65752024-10-011711131113910.1159/000541341541341Delayed Distant Recurrence of a Uveal Melanoma 4 Decades after EnucleationNils A. Eide0Agate Noer1Henrik Jespersen2Peter Jebsen3Jürgen Geisler4Department of Ophthalmology, Oslo University Hospital, Oslo, NorwayDepartment of Ophthalmology, Oslo University Hospital, Oslo, NorwayDepartment of Oncology, Oslo University Hospital, Oslo, NorwayDepartment of Pathology, Oslo University Hospital, Rikshospitalet, Oslo, NorwayDepartment of Oncology, Akershus University Hospital, Oslo, NorwayIntroduction: This report presents a case of an exceptionally delayed distant recurrence of a choroidal melanoma, occurring 4 decades after the enucleation of the affected eye. Case Presentation: In 1977, a 29-year-old man underwent enucleation for a choroidal melanoma. At the age of 68 years, he was diagnosed with advanced prostate cancer. Although the metastatic prostate cancer responded to treatment, a persistent lung lesion warranted further examination. A lung biopsy, somewhat surprisingly, confirmed the presence of melanoma metastasis, 4 decades after the enucleation. The cells were positive for Melan-A, while no BRAF mutation was identified. Two years later, new lesions appeared in the liver, and CT showed progression with multiple new sites. A liver biopsy revealed again melanoma recurrence, and its choroidal origin was verified by the presence of a GNA11 mutation. The patient underwent radiation therapy for the lung and liver lesions, followed by immunotherapy. However, the patient died 11 months after the recurrence in the liver. In this case report, the micrometastatic melanoma cells appear to have remained dormant for an extended period, before the patient’s treatment in 1977, but the reason for the late reactivation from the dormant state remains unclear. Conclusion: The recurrence of a choroidal melanoma is substantiated by the histopathological and molecular analyses, including the finding of a GNA11 mutation. This case exemplifies a remarkably delayed distant recurrence of a choroidal melanoma, which manifested clinically 40 years following enucleation.https://beta.karger.com/Article/FullText/541341case reportdormancygna11late recurrenceuveal melanoma
spellingShingle Nils A. Eide
Agate Noer
Henrik Jespersen
Peter Jebsen
Jürgen Geisler
Delayed Distant Recurrence of a Uveal Melanoma 4 Decades after Enucleation
Case Reports in Oncology
case report
dormancy
gna11
late recurrence
uveal melanoma
title Delayed Distant Recurrence of a Uveal Melanoma 4 Decades after Enucleation
title_full Delayed Distant Recurrence of a Uveal Melanoma 4 Decades after Enucleation
title_fullStr Delayed Distant Recurrence of a Uveal Melanoma 4 Decades after Enucleation
title_full_unstemmed Delayed Distant Recurrence of a Uveal Melanoma 4 Decades after Enucleation
title_short Delayed Distant Recurrence of a Uveal Melanoma 4 Decades after Enucleation
title_sort delayed distant recurrence of a uveal melanoma 4 decades after enucleation
topic case report
dormancy
gna11
late recurrence
uveal melanoma
url https://beta.karger.com/Article/FullText/541341
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AT henrikjespersen delayeddistantrecurrenceofauvealmelanoma4decadesafterenucleation
AT peterjebsen delayeddistantrecurrenceofauvealmelanoma4decadesafterenucleation
AT jurgengeisler delayeddistantrecurrenceofauvealmelanoma4decadesafterenucleation