Eye-preserving surgery removes large melanoma and improves woman’s vision

Surgeons in Taipei removed a large cancerous tumour from a 36-year-old woman’s right eye while preserving the eye and improving her vision from 0.3 to 0.8.

The woman sought care after experiencing persistent blurred vision and a dark area in her field of view. Dilated examination, retinal imaging and ultrasound revealed a choroidal melanoma measuring 22.5 millimetres across and 12.5 millimetres high. It occupied roughly half of the eyeball and was too large for standard plaque brachytherapy.

After considering the tumour’s size, position and the woman’s remaining vision, the Taipei Veterans General Hospital team performed posterior lamellar sclerouvectomy, known as PLSU. During the five-to-six-hour procedure, surgeons approached from outside the eye, carefully separated part of the outer wall and removed the tumour and affected tissue while limiting damage to the retina and other important structures.

At the latest reported follow-up, the cancer had neither returned nor spread. Continued whole-body monitoring remains important because choroidal melanoma can travel through the bloodstream to other organs.

The condition is rare in Taiwan, with an estimated 20 to 30 cases annually. Doctors said treatment must be tailored to each patient, balancing cancer control, surgical safety and the possibility of preserving useful sight.