Accuracy of presumed uveal melanoma diagnosis before alternative therapy.

AIMS/BACKGROUND This study was performed to ascertain the diagnostic accuracy rate of non-invasive tests in patients with presumed uveal melanomas scheduled to be treated with either irradiation or cyclochoroidectomy. METHODS One hundred consecutive patients who had non-invasive tests followed by fine needle aspiration biopsy (FNAB) as prior alternative treatment were analysed retrospectively. RESULTS In 86 cases the diagnosis of uveal melanoma was confirmed on FNAB. In five cases false negative results were obtained. In nine patients a diagnosis other than a uveal melanoma was made on the basis of cytopathology. No significant morbidity and no evidence of tumour spread occurred. CONCLUSION In presumed uveal melanomas eligible for treatment with alternative therapies, the diagnostic accuracy of non-invasive tests is not as good as with larger tumours that require enucleation. Fine needle aspiration biopsy data resulted in correct management of 9% of cases that were thought to have uveal melanomas on non-invasive tests, but had other lesions on cytopathological evaluation.