The ocular oncology community is divided over when to treat small choroidal lesions: when they present with the risk of growth based on the TFSOM clinical standard or when they actually grow.
The above graphic, (click on image for a larger size), uses everyday images to illustrate the size differences between a choroidal nevus (less than 5 mm) and small, medium and large-sized choroidal melanomas (5-18 mm).
• A choroidal nevus is a lesion that is roughly the size of the end of a small birthday candle or less than 5 mm in diameter.
• Small choroidal melanomas range in diameter from 5 – 10 mm, or from the eraser top of a pencil to the bottom of a AAA battery.
• Medium choroidal melanomas range in diameter from 10 - 15 mm, or from a size slightly smaller than a watch battery to the bottom end of a tube of lip balm.
• Large choroidal melanomas are more than 15 mm in diameter, or at least dime and penny-sized eye cancers.
Eye cancers larger than 18 mm in diameter are usually enucleated (removed). First, the globe cannot tolerate the radiation doses required to successfully treat such a large cancer. Secondly, to prevent recurrences, treatment usually extends 2-3 mm beyond the tumor's edge. Since the COMS plaques range in size from 12 - 20 mm, a safety margin around a 19 mm tumor is not possible raising the risk of recurrence.
The above graphic, (click on image for a larger size), uses everyday images to illustrate the size differences between a choroidal nevus (less than 5 mm) and small, medium and large-sized choroidal melanomas (5-18 mm).
• A choroidal nevus is a lesion that is roughly the size of the end of a small birthday candle or less than 5 mm in diameter.
• Small choroidal melanomas range in diameter from 5 – 10 mm, or from the eraser top of a pencil to the bottom of a AAA battery.
• Medium choroidal melanomas range in diameter from 10 - 15 mm, or from a size slightly smaller than a watch battery to the bottom end of a tube of lip balm.
• Large choroidal melanomas are more than 15 mm in diameter, or at least dime and penny-sized eye cancers.
Eye cancers larger than 18 mm in diameter are usually enucleated (removed). First, the globe cannot tolerate the radiation doses required to successfully treat such a large cancer. Secondly, to prevent recurrences, treatment usually extends 2-3 mm beyond the tumor's edge. Since the COMS plaques range in size from 12 - 20 mm, a safety margin around a 19 mm tumor is not possible raising the risk of recurrence.
A 12 mm (watch battery-sized) tumor will be treated with at least a 14 mm (AA battery-sized) plaque. In contrast, small melanomas of 7 mm (pencil eraser-sized) in diameter will still be treated with the 12 mm plaque - the smallest currently available plaque size. Proton beam (pg. 19) is also a treatment option for choroidal melanomas.
If you have been diagnosed with a small suspicious or a medium to large-sized choroidal melanoma, this graphic can put the size of your lesion/eye cancer into context using everyday examples which are easily found in a utility drawer or change purse.
4 comments:
Question please - I have just found a 10mm Melanoma that 2 docs have said is very large on my left eye. Mayo Clinic in Jacksonville said it is "big" and they recommend to remove the eye. Your chart puts it into the small to medium range. Who would you recommend for a second opinion? Thanks, CIndy
I would not muck around with it, I was told by 3 Dr, that I will need liver scan 2 x Year, I saw 3 Dr, I had already decided to have my eye removed
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Thanks, Robert
Thanks for great information you write it very clean. I am very lucky to get this tips from you.
Treatment for Melanoma
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