Epidemiological and clinical aspects of uveal melanoma in west Algeria

Introduction: Uveal melanoma (UM) is a rare cancer whose prognosis remains poor despite considerable advances in early diagnosis and quality of care achieved in developed countries. However, its annual incidence has been steadily increasing over the past twenty years. We diagnose 2 to 3 cases of uveal melanoma per year. In the Algerian context, we have identified elements that seem to justify our study, in particular a lack of information on its epidemiology, and real difficulties in its management.

Materials and methods: Our work was carried out with sixty-three cases of uveal melanoma, collected over a period of eighteen years (2001-2018) through a descriptive study with prospective collection, carried out in a referral center in western Algeria, including two specialized ophthalmology departments. 

Results: The average age at diagnosis was 53.7 ± 3.4 years, with a slight female predominance, sex ratio = 0.9, 79.3% of patients had fair skin, the average time to diagnosis was 12, 3 weeks with extremes [7.7-16.9], the equatorial location was the most frequent with a rate of 55.5%. The largest tumor diameter was >10mm in 62% of patients, with an average of 11.2mm with extremes [4.0-18.3], the thickness was > 5mm in 81% of patients with an average of 8mm with extremes [1.61-16.8]. Secondary retinal detachment was found in 68% of patients on Optical Coherence Tomography. The neoformation was pigmented in 87.3%, achromic in 9.5%, and heterogeneous in 3.2%. The neoformation was dome-shaped in 46% of patients, rounded in 39.7%, mushroom in 11, 1%, shirt button in 1.6%, the shape was annular in only one case. 

Conclusion: Our results indicate that our patients are affected at a younger age, in comparison with the European and North American populations, among the main characteristics of the neoformations, a greater thickness and a smaller diameter, with a high proportion of rupture of the Bruch blade.