The Management of Choroidal Melanoma

There are many unanswered questions regarding the correct treatment of malignant melanoma of the choroid. The complexity of cancer is well recognized. Some feelchimera(an animalistic monster) would be a more appropriate term. But the problem for ophthalmology may lie in the Ptolemaic view that has prevented us from seeing the disease beyond the eye. See also p 1477. This editorial does not address the following important questions: Is enucleation associated with an increased likelihood of metastatic seeding? Is radiation therapy a more effective treatment than enucleation? Which form of radiation therapy is most effective? Should adjuvant chemotherapy be used with enucleation or with radiation therapy? It does address the questions that arise when one considers hyperthermia as a treatment modality for choroidal melanoma. Furthermore, the discussion pertains only to the local treatment of a malignant neoplasm known to have a substantial mortality associated with metastasis. Whether a malignant