Metastasis from untreated uveal melanomas.

From 1969 to 1985, 224 cases of choroidal or ciliary body malignant melanoma had metastatic evaluations at the Mayo Clinic, Rochester, Minn. Five cases (2.2%) were found to have evidence of metastasis during the pretreatment evaluation. In each case, metastatic melanoma was verified histologically. Prior to enucleation or radiation treatment, we recommend a general medical evaluation, liver enzyme studies, and chest roentgenogram. Computed tomography (CT) of the liver should be performed if liver involvement is suggested by either the general medical evaluation or liver enzyme studies. Although CT of the liver in the initial surveillance of patients with choroidal or ciliary body melanoma is routinely performed at our institution, CT is not likely to produce a high yield of detectable disease in the presence of normal liver enzyme levels.