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Review
. 2024 Mar 14;41(1):20-26.
doi: 10.1055/s-0043-1777712. eCollection 2024 Feb.

Immunoembolization for the Treatment of Uveal Melanoma Hepatic Metastases

Carin F Gonsalves  1
Affiliations
Review

Immunoembolization for the Treatment of Uveal Melanoma Hepatic Metastases

Carin F Gonsalves. Semin Intervent Radiol. .

Abstract

Uveal melanoma is the most common primary intraocular tumor in adults. Approximately 50% of patients develop metastatic disease despite successful treatment of the primary eye tumor. The liver is the most common site of metastatic disease occurring in more than 90% of patients. Clinical prognosis is dependent on the ability to control the growth of liver tumors. Locoregional therapies play an important role in stabilizing liver metastases, prolonging survival for patients with metastatic uveal melanoma. As overall survival is prolonged, the development of extrahepatic disease becomes more common. Immunoembolization, a form of liver-directed therapy, not only focuses on treating hepatic metastases by stimulating the local immune system to suppress the growth of liver tumors, but it potentially generates a systemic immune response delaying the growth of extrahepatic metastases as well. The following article discusses immunoembolization for the treatment of metastatic uveal melanoma including the rationale, mechanism of action, indications, contraindications, outcomes, and associated toxicities.

Keywords: granulocyte macrophage-colony-stimulating factor; immunoembolization; interventional radiology; liver-directed therapy; uveal melanoma.

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Figures

Fig. 1
Fig. 1
Multiple melanoma metastases on the surface of the liver (arrows) in a patient undergoing surgical resection for a presumed solitary tumor.
Fig. 2
Fig. 2
( a and b ) Contrast-enhanced MRI with gadoxetate disodium (Eovist). Multiple metastatic uveal melanomas (arrows) appear as “holes” in the liver on delayed phase or hepatobiliary phase imaging.
Fig. 3
Fig. 3
Uveal melanoma metastases (arrows) appear bright on MRI diffusion-weighted imaging.
Fig. 4
Fig. 4
( a ) Large tumor (arrow) in the right lobe of the liver identified on contrast-enhanced MRI. ( b ) Rapid progression of untreated metastatic uveal melanoma on repeat MRI performed 4 weeks later demonstrating the aggressive nature of this disease and the rationale for contemporaneous imaging prior to treatment.
See this image and copyright information in PMC

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