Reduction of Nodular Growth Pattern of Metastatic Uveal Melanoma after Radioembolization of Hepatic Metastases

• Published in: Ocular oncology and pathology Vol. 2; no. 3; pp. 160 - 165
• Main Authors: Halenda, Kevin M, Kudchadkar, Ragini R, Lawson, David H, Kies, Darren D, Zhelnin, Kristen E, Krasinskas, Alyssa M, Grossniklaus, Hans E
• Format: Report
• Language: English
• Published: 01.04.2016
• ISSN: 2296-4681
• DOI: 10.1159/000442950

AIMThe aim of this study was to report a case of metastatic uveal melanoma in which radioembolized nodular liver metastases decreased in size while infiltrative sinusoidal metastases progressed, leading to jaundice without obstruction of the biliary ducts. METHODSThe relevant clinical features, imaging, and histopathologic findings of this case are reviewed. RESULTSA 61-year-old Caucasian male with a history of uveal melanoma of the left eye status post plaque brachytherapy developed numerous liver metastases. After progression on systemic therapies, he underwent palliative radioembolization. Despite some radiographic improvement in the liver metastases, he developed hyperbilirubinemia without biliary tract obstruction or signs of liver failure. A biopsy of radiographically normal liver demonstrated extensive sinusoidal infiltration with melanoma. CONCLUSIONSDistinct angiographic and histopathologic growth patterns of metastatic uveal melanoma differ in their amenability to radioembolization. Sinusoidal infiltration may lead to hyperbilirubinemia in the absence of overt obstruction or liver failure.