Uveal Melanoma Essay

872 words - 4 pages

Uveal melanoma is a rare malignancy occurring in the eye. The uveal tract consists of the intraocular structures of the iris, choroid, and ciliary body. Melanoma of the iris is the least common form of uveal melanoma. Choroid melanoma is associated with the poorest prognosis. Metastasis from the choroid occurs frequently and often involves liver metastasis. Despite its rarity, uveal melanoma is the most common non-cutaneous melanoma. Though the causes of uveal melanoma are poorly delineated, exposure to ultraviolet radiation and characteristics of pigment are predicted as risk factors leading to oncogenic mutation and subsequently, the rare manifestation of uveal melanoma.

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In addition to UV radiation’s ability to suppress immune reactions, UVB is a complete carcinogen that can have direct effects on DNA. UVA makes up the majority of the UV spectrum and tends to penetrate tissues deeper, but is not easily absorbed by the DNA and acts indirectly through the formation of reactive oxygen species. These reactive oxygen species often lead to differential expression of p53 and bcl-2 proteins responsible for regulating UV-induced apoptosis.

Susceptibility to solar UV radiation varies among individuals. Much as lighter skin increases the risk of cutaneous melanoma, those with lighter iris color may be more at risk than those with a darker iris color. A case study showed that of the patients with uveal melanoma, 78% had a light iris color (48% blue or gray, 30% green or hazel) while only 23% had brown eyes. The risk of those with lighter eye color was found to be 1.7 times that of persons with brown eyes. Another portion of the population at higher risk includes individuals with Xeroderma Pigmentosum, which greatly increases the risk of chromosomal damage or mutation. Individuals that utilize tanning lamps are at a high risk due to the intense UV radiation exposure, specifically UVA exposure. This exposure is particularly harmful as the wavelengths emitted by tanning lamps may be higher than those from the sun. Welding equipment also emits intense UV radiation. A high incidence of uveal melanoma in those that use welding equipment often has been observed. Individuals with a family history of uveal melanoma are not presumed to have a significantly higher risk of development.

The early oncogenic mutations involved with uveal melanoma appear to involve the mitogen-activated protein kinase...

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