Dijagnostika i liječenje uvealnog melanoma

master's thesis

• Title (english): Diagnosis and treatment of uveal melanoma
• Author: Matea Severin
• Mentor: Nenad Vukojević (mentor)
• Committee member: Tomislav Jukić (predsjednik povjerenstva)
• Committee member: Miro Kalauz (član povjerenstva)
• Committee member: Nenad Vukojević (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Ophthalmology and Optometry); Zagreb
• Defense date and country: 2022-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Ophthalmology

Abstract

Uvealni melanom najčešći je primarni intraokularni maligni tumor u odraslih osoba. U gotovo 90% slučajeva tumor zahvaća žilnicu dok rjeđe zahvaća cilijarno tijelo i šarenicu. Obično nastaje mutacijom u GNAQ ili GNA11. Čimbenici rizika uključuju svijetlu put, svijetle oči, nemogućnost tamnjenja, očnu melanocitozu, sindrom displastičnog nevusa i mutaciju BAP1.
Uspješna dijagnoza bazira se na cjelovitom oftalmološkom pregledu na biomikroskopu s metodom indirektne oftalmoskopije. Nadalje, dijagnozu nadopunjuju i potvrđuju slikovne metode poput ultrazvuka i ultrazvučne biomikroskopije, angiografije i fundus autofluorescence, optičke koherentne tomografije, kompjuterizirane tomografije te magnetske rezonance. Biopsija je metoda izbora ukoliko se ostale metode pokažu neuspješnima.
Terapijske opcije za uvealni melanom konstantno napreduju pa je shodno s tim enukleacija uglavnom zamijenjena različitim oblicima radioterapije, fototerapije i lokalnom resekcijom tumora. Ove konzervativnije metode liječenja nude dobru lokalnu kontrolu tumora. Brojne su mogućnosti liječenja metastatske bolesti koja se javlja u 50% slučajeva, no još uvijek su nedostatne u sprječavanju smrtnog ishoda.

Abstract (english)

Uveal melanoma is the most common primary intraocular malignant tumor in adults. In almost 90% of cases, the tumor affects the choroid, while less often it affects the ciliary body and the iris. It is usually caused by a mutation in GNAQ or GNA11. Risk factors include fair skin, light-coloured eyes, inability to tan, ocular melanocytoma, dysplastic nevus syndrome, and BAP1 mutation.
A successful diagnosis is based on a complete clinical examination on slit lamp using indirect ophthalmoscopy. Furthermore, imaging methods such as ultrasound and ultrasound biomicroscopy, angiography and fundus autofluorescence, optical coherence tomography, computerized tomography and magnetic resonance imaging complement and confirm the diagnosis. Biopsy is the method of choice if other methods prove unsuccessful.
Therapeutic options for uveal melanoma are constantly developing, and accordingly, enucleation has mostly been replaced by various forms of radiotherapy, phototherapy and local tumor resection. These more conservative treatment methods offer good local tumor control. There are numerous treatment options for metastatic disease, which occurs in 50% of cases, but they are still insufficient in preventing a fatal outcome.

• Keywords: angiografija; brahiterapija; fototerapija; melanom; metastatska bolest
• Keywords (english): angiography; brachytherapy; phototherapy; melanoma; metastatic disease
• Language: croatian
• URN:NBN: urn:nbn:hr:105:490221
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-02-15 11:55:33