The present review summarizes and integrates the results from recent studies on the metastatic behavior and immunology of intraocular melanomas in mice. The data suggest strongly that enucleation of a melanomacontaining eye promotes intravascular showering of melanoma emboli that, in the immunologically compromised host, develop into fulminant metastases. By contrast, similarly disseminated melanoma cells are rejected by T-cell-dependent immune mechanisms in the immunocompetent host. Preliminary results suggest that this immune rejection is mediated by cytotoxic T-lymphocytes. Several independent experiments showed that neither enucleation nor immune impairment alone is capable of inducing progressive metastases in the intraocular melanoma-bearing host. Thus, the development of progressive metastases from intraocular melanomas is a two step process requiring: (1) a surgeryinduced, intravascular showering of melanoma emboli and (2) a simultaneous impairment of T-cell-dependent immune functions. The present results support the Zimmerman-McLean hypothesis that enucleation of a melanoma-containing eye can (under defined conditions) promote the metastatic spread of the primary tumor. The finding that immunocompetent intraocular melanoma-bearing hosts reject disseminated metastases offers hope that immunotherapeutic maneuvers may greatly reduce the risk of metastatic disease.
- intraocular melanoma
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