Forgetting malignancies

Summary Masquerade syndromes are a rare group of neoplastic or non‐neoplastic disorders that present as uveitis. Approximately 40% of all uveitis cases remain idiopathic despite exhaustive clinical and laboratory investigations. The consequence of missing a malignant masquerade syndrome can be devastating. Among uveitis patients older than 60 years, malignancy constitutes 1.5‐5% of all cases. Among uveitis patients of all ages malignant masquerade syndromes constitute only 2‐3% of cases in tertiary uveitis centers. There are some distinguishing characteristics between uveitis patients and neoplastic masquerade patients: patients with neoplastic masquerade often present at an older age, have unilateral disease and posterior segment involvement and are more likely to be Caucasian. Diagnosis of malignancies in the eye can be difficult but important and clinical features at presentation can help raise suspicion. Early diagnosis and intervention not only saves vision and improve quality of life but it can also be life‐saving.