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

AIM

The 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.

METHODS

The relevant clinical features, imaging, and histopathologic findings of this case are reviewed.

RESULTS

A 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.

CONCLUSIONS

Distinct 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.

Pelvic Congestion Syndrome: A Review of Current Diagnostic and Minimally Invasive Treatment Modalities

Chronic pelvic pain is a debilitating medical condition with a host of potential causes. Although often overlooked, pelvic congestion syndrome (PCS) is a well-established cause of chronic pelvic pain due to abnormal ovarian and pelvic varices. The diagnosis is established with modern non-invasive cross-sectional imaging, preferably contrast enhanced magnetic resonance imaging. Although medical and open surgical therapies exist, transcatheter percutaneous embolotherapy has been shown to be a safe, effective and durable therapy for the treatment of PCS. Further prospective randomized studies are needed to refine optimal technique and assess long-term patient outcomes.