Achados ultrassonográficos em pacientes com melanoma uveal submetidos à braquiterapia

Achados ultrassonográficos em pacientes com melanoma uveal submetidos à braquiterapia


Maristela Amaral Palazzi,
Martha M. Motono Chojniak


Arquivos Brasileiros de Oftalmologia

versão impressa ISSN 0004-2749versão On-line ISSN 1678-2925

Arq. Bras. Oftalmol. vol.57 no.5 São Paulo out. 1994


The authors present the ecographic findings evaluated before and after treatment in fifty eight patients with clinical diagnosis of choroidal melanoma submitted to brachytherapy emphasizing the importance of serial U.S. evaluations in the control of tumor response to irradiation.

Changes in the pattern of internal reflectivity ocurred after treatment in 39.2% of patients.

Rupture of Bruch's membbrane was verifyed at diagnosis in 41.3% of patients and after therapy in 03 cases.

Choroidal excavation was found at diagnosis in 90.5% of patients with no change after treatment.

Retinal detachment presented by 72% of patients at diagnosis, disappeared in 38.8%, increased in 5.5% and remained unchanged in 38.8% of patients.

In relation to tumoral dimensions, it was observed that the tumor height reduced after therapy in 64% of patients, remained the same in 28% and increased in 8% of cases.

Vitreous hemorrhage ocurred only after treatment, in 05 patients (8.6%). Scleral and/or Tenon 's space oedema was seen only after treatment, in 76.3% of patients.

Scleral invasion by the tumor was suggested in 03 patients of whom 02 were histologically proven.


1 ABRAMSON, D. H.; SERVODIDIO, C. A.; McCORMICK, B.; FASS, D.; ZANG, E.: Changes in height of choroidal melanomas after plaque therapy. Br. J. Ophthalmol., 74: 359-62, 1990.
2 AUGSBURGER, J. J.; SHIELDS, J. A.; et al.: Post-irradiation regression of choroidal melanomas as a risk factor from metastatic disease. Ophthalmology, 94: 1173-77, 1987.
3 BEDFORD, M. A.: The use and abuse of Cobaltplaques in the treatment of chroidal malignant melanoma. Trans. Ophthalmol. Soc. UK., 93: 139-43, 1973.
4 BYRNE, S. F. & GREEN, R.: Intraocu1ar tumors. In: Ultrasound of the eye and orbit. St Louis, Mosby Year Book, 1992.
5 COLEMAN, D. J.; ABRAMSON, D. H.; JACK, R. L.; FRANZEN, L. A.: Ultrasonic diagnosis of tumors of the choroid. Arch. Ophthalmol. 91: 344-54, 1974.
6 COLEMAN, D. J.; LIZZI, F. L.; SILVERMAN, R. H. et al.: Regression of uveal malignant melanomas following Cobalt-60 plaque. Retina, 5: 73-8, 1985.
7 COLEMAN, D. J.; SILVERMAN, R. H.; RONDEAU, M. J.; COLEMAN, J. A.; ROSBERGER., D.; ELLSWORTH, R. M.; LIZZI, F. L.: Ultrasonic tissue characterization of uveal melanoma and prediction of patient survival after enucleation and brachytherapy. Am. J. Ophthalmol., 112: 682-88, 1991.
8 CRUESS, A. F.; AUGSBURGER, J. J.; SHIELDS, J. A.; BRADY, L. W.; MARKOE, A. M.; DAY, J. L.: Regression of posterior uveal melanoma following Cobalt-60 plaque radiotherapy. Opthalmology, 91: 1716-19, 1984.
9 FULLER, D. G.; SNYDER, W. B.; HUITON, W. L.; VAISER, A.: Ultrasonographic features of chroidal rnalignant melanomas. Arch. Opthalmol., 97: 1465-72, 1979.
10 GUTHOFF, R.: Echographic Diagnosis of 1ntraocular Disease. In: Ultrasound in ophthalmologic diagnosis. New York, Thieme Medical Publishers, Inc., 1991.
11 MUNDT, G. H.; HUGHES, W. S.: Ultrasonics in ocular diagnosis. Am. J. Ophthalmol. 41: 488, 1956.
12 NICHOLSON, D. H; BYRNE, S. F.; CHIU, M. T.; SCHIFFMAN, M. S.; HUGHES, J. R.; NOVINSKI, E. K.: Echographic and Histologic tumor heigh measurements in uveal melanoma. Am. J. Ophthalmol., 100: 455-57, 1985.
13 SAMPAOLESI, R. MELANOMA: In: Ultrasonidos en Oftalmologia. Buenos Aires, Editorial Médica Panamericana, 1983.
14 SHIELDS, J. A.; AUGSBURGER, J. J.; BRADY, L. W.; DAY, J. L.: Cobalt plaque therapy of posterior uveal melanoma. Opthalmology, 89: 1201-7, 1982.