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Extrascleral extension of choroidal melanoma increases the risk of metastasis.1 Anterior extrascleral extension can be treated by local resection with enucleation or scleral reinforcement after local radiation therapy. Advanced cases are dealt with by enucleation with resection of all viside orbital melanoma followed by radiation. External beam radiation therapy (EBRT) is used for presumed residual microscopic orbital melanoma.2 Massive extrascleral extension may require orbital exenteration (also followed by irradiation).3 Treated similarly, extrascleral extension can also occur after plaque radiation, local resection and trans-scleral thermotherapy (TTT).4
Radiation therapy is used to reduce the rates of orbital and systemic recurrence.5,6 We report on the first use of orbital brachytherapy as an alternative to EBRT for extrascleral extension of choroidal melanoma.
A 63-year-old man presented to The New York Eye Cancer Center, with an American Joint Committee on Cancer …
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