Choroidal melanoma is the most common primary intraocular tumor in adults. Its metastatic spread characteristically goes first to the:
- A Liver (via the portal system and hepatic blood supply, since the choroid drains via vortex veins into the systemic circulation) ✓
- B Brain and lung
- C Bone marrow and lymph nodes
- D Lungs exclusively, similar to most solid tumors
Correct answer: A. Liver (via the portal system and hepatic blood supply, since the choroid drains via vortex veins into the systemic circulation)
Explanation
Uveal (choroidal) melanoma has a unique metastatic pattern — it spreads almost exclusively hematogenously (uveal tissue has no lymphatics), and the liver is overwhelmingly the most common site of metastasis (present in >90% of metastatic cases). This is because choroidal venous drainage via the vortex veins enters the systemic circulation and the hepatic blood supply. Liver metastases from uveal melanoma carry a poor prognosis. This differs from cutaneous melanoma which can spread to lungs, brain, and lymph nodes early.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.