ADVANCED UVEAL MELANOMA WITH SUBDURAL METASTASIS MIMICKING MENINGEOMA - A CASE REPORT

Uveal melanoma is a rare malignancy. Its clinical course is highly agressive. At the time of diagnosis, extraocular extension is present in most of the cases. We present a case of 69-year-old white man admitted for sharp orbital pain. Advanced uveal melanoma was diagnosed. We found black-colored tumor protruding from the left eye and multiple cutaneous metastases on the scalp. CT scan revealed intracranial tumor mimicking meningeoma in the left parietal region. Lymhogenous metastases were not found and other hematogenous metastases were excluded. After biopsy of the eye tumor and excisional biopsy of one skin tumor, the uveal melanoma was diagnosed and the left orbital exenteration and extirpation of intracranial tumor were performed. The reconstruction was performed using galeacutaneous flap harvested from craniotomy flap. Postoperative course was uneventful and the patient was released from pain. He refused the additional oncological treatment. After four months, he died of liver metastatic disease. The uveal melanoma is highly aggressive malignancy and isolated subdural metastasis is quite rare. The reconstruction with transposed galeacutaneous flap is versatile and secure technique after orbital exenteration. Acta Medica Medianae 2011;50(1): 47-50.