Multiple malignant melanomata of the uveal tract in one eye.

THE literature on malignant melanoma of the uveal tract is extensive but case reports of multiple malignant tumours of this type are infrequent. Freckles and naevi are present in approximately 50 per cent. of normal eyes and "are even more frequent and larger in eyes which also contain malignant melanoma of the uveal tract" (Hogan and Zimmerman, 1962). According to Reese (1956), when the malignant melanoma was present in the choroid an associated benign melanoma in the iris occurred in 7 5 per cent. of cases; when the malignant melanoma was primary in the iris or ciliary body, the association was seen in approximately 20 per cent. of cases. The presence of several malignant pigmented neoplasms could be explained either by the demonstration of metastatic dissemination from a single primary growth or by postulating independent multifocal origins. Reese (1956) stated: "I have seen only one instance of an implantation lesion on the iris from a malignant melanoma of the choroid". Reese (1963) observed that he knew of no authenticated case on record of multiple primary neoplasms of the choroid in a single eye. Rosen and Moulton (1953) reported a case of multiple malignant melanomata of the uveal tract proved by serial section; they described a malignant melanoma of the ciliary body, multiple malignant melanomata of the choroid, and a benign melanoma of the choroid, but published no histological photographs. Frayer (1956) presented a case of malignant melanoma of the iris and ciliary body and a second choroidal melanoma, at a meeting of the Faculty of Ophthalmology of the College of Physicians, Philadelphia; these tumours were considered to have arisen independently of each other. The present paper describes three separate uveal melanomatous tumours, two of them malignant, in a single eye.