Treatment of Uveal Melanoma with a Large Tumour or Extrascleral Extension

Clinical Scenario

This protocol applies to patients with uveal melanoma presenting as a large tumour, or with extrascleral extension — features that define a distinct surgical and oncological situation requiring specific management decisions.

Specific Presentation

When This Protocol Applies

Enucleation is indicated for large uveal melanoma tumours and for tumours where disease has extended beyond the sclera. The surgical approach in these cases differs from eye-conserving strategies used in smaller lesions.

Treatment Approach

Management involves a surgical intervention, and for patients identified as being at elevated risk of local recurrence following surgery, an adjuvant radiation-based approach may be incorporated. Full eligibility criteria, sequencing, and all supporting options are available in the structured protocol.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.esmoop.2026.106888

Enucleation should be limited to large tumours and tumours with extrascleral extension [II, A].
For patients with a high risk of local recurrence (i.e. positive margins after enucleation or extraocular tumour extension), adjuvant external beam RT can be recommended [II, B].

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