Choroidal melanoma: a disease with an “irrational” behaviour

Recently Dr.Oliver Sacks, a very well Known neurologist and a prolific writter announced that he has been diagnosed of liver metastases from choroidal melanoma. His letter in internet had been shared thousands of times because is full of gratitude, emotion and inspiration for all of us. As an oncologist myself  working with cutaneous and ocular melanoma patients this situation brougth to my mind the “irrational behaviour” of melanoma in general and ocular melanoma in particular. Symptoms are related with visual problems but doctors needs to be aware about this diagnosis. My last patient, a tennis player, went to the doctor because he couldn see a ball playing a match…

In the past ten years we saw a development of several new drugs for cutaneous melanoma treatment, and some patients can be cured even with metastases. We know a lot about choroidal melanoma, a low incidence disease. We know less about its epidemiology but some patients remembered a previous diagnosis of cutaneous melanoma in some familiar members. There is an intriguing peculiarity: liver metastases are much more common than lung metastases in ocular melanoma, why ? I,m sure that in the next future we will find the answer. Melanoma treatment are evolving rapidly, and I,m sure that we will find a definitive solution for melanoma, even for ocular or choroidal melanoma.