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Bilateral choroidal metastases as presentation of dissemination of cutaneous malignant melanoma
Author(s) -
FERNANDEZPEREZ S,
SATUE M,
GARCIAMARTIN E,
BAMBO M,
PRIETO E,
DE LA MATA G,
PUEYO V,
RUIZMORENO O
Publication year - 2012
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.1755-3768.2012.s015.x
Subject(s) - medicine , choroid , melanoma , visual acuity , serous fluid , blurred vision , retinal detachment , posterior pole , ophthalmology , surgery , dermatology , retina , pathology , retinal , physics , cancer research , optics
Purpose To report the case of a patient with bilateral choroidal mestastases as the first sign of dissemination of cutaneous malignant melanoma. Methods A 47‐year‐old Caucasian male presented to our emergency department with rapid‐onset blurred vision in his right eye (RE). Ophthalmoscopic examination revealed multiple pigmented placoid lesions located in the posterior pole and half periphery of the retina of both eyes and a serous macular detachment in RE. Optical coherence tomography confirmed the macular neurosensory detachment in the RE Since clinical suspicion of choroidal metastases, we referred the patient to the Oncology Department for systematic study. After an exhaustive study, they concluded that it was a dissemination of a cutaneous malignant melanoma with bilateral choroidal metastases, liver and spleen metastases. Results The patient underwent palliative treatment with chemotherapy with improvement of the visual acuity and reduction of the macular neurosensory detachment in the RE. Nevertheless the patient died months later of the diagnosis of cutaneous melanoma dissemination. Conclusion Dissemination of cutaneous melanoma to the choroid is rare and is a major prognostic factor. In general the treatment of ocular metastases is palliative, because the presence of metastases indicates hematogenous spread of tumor. The objectives are therefore to maximize the quality of life and restore or preserve vision.