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    My husband has had two primaries, Stage 1B and in-situ. Recently he started having trouble with his eye — a drooping eyelid and wandering eye. Long story short, ophthalmologist found swelling of the optic disc and sent him for an MRI. Radiologist report as follows:

    Multifocal FLAIR hyperintensity involving the left parietal lobe, left occipital lobe, and posterolateral right frontal lobe, as well as the right temporal lobe. Much of the signal abnormality appears related to small cortical venous structures, although the right temporal lobe signal abnormality is less convincingly contiguous with a vascular structure. This could represent

    vasculitis, particularly if the patient is receiving immunotherapy therapy for the given history of melanoma. Areas of subacute infarct are thought to be less likely, given the apparent vascular nature. Perineural metastatic disease cannot be excluded, but is less likely.

    Husband had no immunotherapy, so that diagnosis is not accurate. Radiologist suggested rescan in three months. Ophthalmologist referred to neurologist, but no appointments available until the end of August. There is a melanoma clinic in Denver, so I contacted them to see if they would do a read on the MRI. They would not without having him as a patient, and so we have an initial appointment this week.

    My question is this — am I overreacting here? Part of me says that the chances of this being melanoma metastases is very,very low, so why am I putting my husband through this anxiety. The other part of me says that we need to rule out the worst case scenarios as quickly as possible.


    Catherine Poole

    This diagnosis sounds unlikely. There is ocular melanoma that starts in the eye and then there is cutaneous melanoma that is unlikely to spread to the eye. I would suggest you move his treatment to Denver to the melanoma clinic where they will also have an ocular specialist. Making speculations based on his having immunotherapy is really not very professional. Dr. Rene Gonzales is excellent and should be able to direct you and your husband properly: http://www.ucdenver.edu/academics/colleges/medicalschool/departments/medicine/MedicalOncology/faculty/Pages/ReneGonzalez.aspx

    Keep in touch

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