A case of choroidal melanocytoma mimicking a choroidal melanoma

Ahmad, Syed Shoeb; Lad, Lalit; Ghani, Shuaibah Abdul

doi:10.1016/j.sjopt.2015.02.002

Cited by 13 publications

(12 citation statements)

References 16 publications

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“…In addition to the disorders mentioned in the preceding section, one must consider diffuse choroidal malignant melanoma [ 37 ], nodular choroidal malignant melanoma with adjacent “horizontal” intrachoroidal proliferation of melanoma cells [ 37 ], nodular choroidal malignant melanoma arising from a broad-based choroidal nevus [ 19 ], and nodular growth of a choroidal melanocytoma [ 38 , 39 ] as lesions in the differential diagnosis of choroidal malignant melanoma associated with isolated choroidal melanocytosis.…”

Section: Discussionmentioning

confidence: 99%

Isolated choroidal melanocytosis: clinical update on 37 cases

Augsburger

Brooks

Corrêa

2020

Graefes Arch Clin Exp Ophthalmol

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Purpose Isolated choroidal melanocytosis is a congenital melanocytic hyperpigmentation involving the choroid that is not associated with iridic or scleral features of ocular melanocytosis. The purpose of this work was to describe the clinical features and course of a relatively large series of patients with this disorder. Methods A retrospective clinical study of 37 patients with isolated choroidal melanocytosis encountered in a single practice 1986–2018 was done. All lesions were 5 mm or larger in the largest basal diameter, homogeneously melanotic, and completely flat by conventional ocular ultrasonography. Results The 37 patients ranged in age from 2 weeks to 87 years (mean 31.5 years, median 18 years) at initial diagnosis of the melanotic choroidal lesion. Arc length largest basal diameter of the melanotic choroidal lesion ranged from 5.5 to 37 mm (mean 14.6 mm, median 13 mm). The lesion extended beneath the fovea in 18 eyes and to the optic disc margin in 6 eyes. Ten of the lesions straddled the ocular equator, but the center point of all of the lesions was posterior to the equator. The retina was fully attached and appeared normal over the melanotic choroidal lesion in each of these eyes. None of the melanotic choroidal lesions exhibited clumps of orange pigment or drusen on its surface. The lesion was unilateral and unifocal in 36 of the 37 patients. One patient had bilateral choroidal melanocytosis that was isolated in one eye but associated with partial iris melanocytosis in the fellow eye. Three adult patients had a choroidal melanoma localized to the patch of choroidal melanocytosis at baseline. One other adult patient had a choroidal melanoma in the fellow eye at baseline. One pediatric patient had viable unilateral non-familial retinoblastoma in the fellow eye and two adult patients had a classic choroidal nevus in the fellow eye. None of the flat patches of choroidal melanocytosis that were monitored periodically after initial diagnosis expanded appreciably during follow-up ranging from 4.9 months to 15.2 years (mean 5.0 years, median 2.3 years). Conclusions Isolated choroidal melanocytosis is a distinct clinical entity that must be distinguished from broad-based choroidal nevus, choroidal melanocytoma, small choroidal malignant melanoma, acquired bilateral patchy-streaky choroidal melanocytic fundopathy associated with disorders such as cutaneous vitiligo and Waardenburg syndrome, acquired bilateral zonal choroidal melanocytic fundopathy, and diffuse uveal melanocytic proliferation associated with systemic cancer. This disorder appears to predispose affected eyes to development of choroidal melanoma arising from the hypermelanotic patch.

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Section: Discussionmentioning

confidence: 99%

Isolated choroidal melanocytosis: clinical update on 37 cases

Augsburger

Brooks

Corrêa

2020

Graefes Arch Clin Exp Ophthalmol

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“…It is a rare benign pigmented tumor. It is classically described as a tumor of the optic nerve head, but there are some exceptional case reports of uveal tract locations [ 2 – 4 ]. In such cases, it can be difficult to clinically differentiate a melanocytoma from a malignant melanoma.…”

Section: Discussionmentioning

confidence: 99%

“…Melanocytoma is a rare pigmented primary benign tumor that is usually located in the optic disc and the anterior portion of the optic nerve [ 1 ] where the clinical diagnosis is relatively easy. However, in very rare instances, it can be localized in any part of the uveal tract (iris, ciliary body, and choroid) [ 2 – 4 ]. We report the case of a 48-year-old woman with a large choroidal lesion of the left eye.…”

Section: Introductionmentioning

confidence: 99%

Large Choroidal Melanocytoma Simulating Choroidal Melanoma: A Difficult Differential Diagnosis and an Inevitable Enucleation

Abdellaoui¹,

Belfaiza²,

Malek³

et al. 2020

Case Reports in Ophthalmological Medicine

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Purpose. To describe a case of choroidal melanocytoma mimicking a melanoma. Methods. Retrospective case report. Patient. A 48-year-old Moroccan woman presented with progressive, painless decreased vision in her left eye for 2 months. Results. Her visual acuity was light perception in the left eye and 20/20 in the right one. Fundus examination and fluorescein angiography of the left eye showed a total retinal detachment with a large superior brownish mass. The clinical examination, B-scan ultrasonography, and magnetic resonance imaging all suggested a malignant melanoma. Consequently, the eye was enucleated. The histopathology later revealed a benign melanocytoma of the choroid. Discussion. Melanocytoma is a rare benign pigmented tumor. It is classically described as a tumor of the optic nerve head, but there are some exceptional case reports of uveal tract locations (iris, ciliary body, and choroid). In such cases, it can be difficult to clinically differentiate a melanocytoma from a malignant melanoma.

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“…This can avoid unnecessary enucleations and thereby protect the quality of life in a young individual. 4 Additional differentials for amelanotic or melanotic choroidal melanoma includes choroidal osteomas, choroidal haemangiomas, choroidal detachment, lymphoma, metasatic carcinoma, subretinal haematoma, localised suprachoroidal haematoma, nodular posterior scleritis or massive gliosis of the retina.…”

Section: Differential Diagnosismentioning

confidence: 99%

Choroidal Melanoma- A Case Report

Mallappa¹,

Nagaraj²,

Parasar³

2017

jebmh

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A 48-year-old female presented to our institute with complaints of diminution of vision in right eye since 3 months. No other ocular complaints. Past history and family history was not significant.Ocular examination revealed visual acuity of 6/60 in right eye and 6/18 in left eye. Anterior segment was normal in both eyes. On dilated fundus evaluation, distant direct ophthalmoscopy showed a mass projecting behind the lens in inferotemporal quadrant from 6 to 9 o'clock position (Figure 1). Indirect ophthalmoscopy revealed a large elevated pigmented lesion approximately 8 DD in size present at posterior pole from 5-8 o'clock hours, approximately 1 DD below the disc with vascularisation seen over the mass (Figure 2). It was associated with retinal detachment from 4-8 o'clock position in inferior quadrant, macula was spared.Clinical observation was correlated on B-scan showing 11 x 11 mm pedunculated mushroom like choroidal mass in inferior quadrant with RD. The lesion had regular round margin with initial prominant spikes followed by internal spikes of moderate-to-low reflectivity (Figure 3). Extrascleral or optic nerve involvement not seen. OCT showed serous RD with normal retinal thickness (Figure 4).With clinical diagnosis of choroidal melanoma, patient was advised for routine blood investigation (including LFT), chest x-ray, CT abdomen, MRI brain and orbit to rule out any metastatic changes. She was referred to higher centre for oncologist and oculoplasty opinion on further management.

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A case of choroidal melanocytoma mimicking a choroidal melanoma

Cited by 13 publications

References 16 publications

Isolated choroidal melanocytosis: clinical update on 37 cases

Isolated choroidal melanocytosis: clinical update on 37 cases

Large Choroidal Melanocytoma Simulating Choroidal Melanoma: A Difficult Differential Diagnosis and an Inevitable Enucleation

Choroidal Melanoma- A Case Report

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