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Case of choroidal melanoma with massive extraocular extension through sclera
Author(s) -
KIMURA M,
OGATA N,
TAKAHASHI K,
SHIMA C,
NISHIMURA T
Publication year - 2008
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2008.669.x
Subject(s) - sclera , enucleation , medicine , choroid , ophthalmology , choroidal melanoma , melanoma , visual acuity , orbit (dynamics) , retina , surgery , biology , cancer research , engineering , aerospace engineering , neuroscience
Purpose To report a case of choroidal melanoma with massive extraocular extension through the sclera. Methods A 64‐year‐old woman presented visual impairment in the right eye with a few months duration. On her first visit, her corrected visual acuity was 10/20 OD. Ocular examination revealed a raised choroidal mass behind the lens and serous retinal detachment in the lower retina. The choridal mass showed a mushroom shaped solid lesion on ultrasonography. The diagnosis of peripheral choroidal melanoma was confirmed by further examinations with the computed tomography, magnetic resonance imaging, and brain perfusion scintigraphy. Results Because no systemic metastasis was found, we proposed her enucleation. However, she refused the enucleation and wished to be followed without any treatment. Seven months later, the tumor showed extraocular extension, and invasion of the subconjunctiva through the sclera. Finally, her right eyeball was enucleated. Histopathologically, the tumor was determined as mixed cell malignant melanoma of the choroid. The eyeball was congested with tumor cells and the tumor showed massive extraocular extension through the sclera to the orbit. The intraocular tumor presented marked necrotic lesions that indicate rapid growth of the tumor. Conclusion Choroidal melanoma extends rapidly, and resulted in extraocular extension through the sclera.