Choroidal Melanoma With Massive Extrascleral Extension in a Young Black Man

Abstract

The reported incidence of choroidal melanoma is low among the general population and is especially low among blacks. Choroidal melanoma is seen most commonly in whites in the sixth to seventh decades. The tumor is complicated by orbital invasion in only a small percentage of cases. This report describes the case of a 38-year-old black man diagnosed with a choroidal melanoma of the right eye. The tumor exhibited extensive orbital invasion. Primary or metastatic disease elsewhere in the body was ruled out, and the patient underwent an eyelid-sparing orbital exenteration. Histopathologic examination of the orbital specimen confirmed the diagnosis of spindle cell-type choroidal melanoma. Orbital invasion by a primary choroidal melanoma in a black person under the age of 40 is highly unusual. To our knowledge, this represents the youngest reported case of choroidal melanoma with extrascleral extension in a black patient. Ophthalmologists should consider the possibility of this potentially deadly tumor, even in young, black patients.

Choroidal melanoma with extrascleral extension in an Australian Aboriginal man

“…The incidence in African‐Americans is 0.2/1 000 000 compared with 6.9/1 000 000 in Caucasians representing a relative risk of 0.03. African‐Americans also have a worse prognosis than Caucasians 3 . The underlying basis for racial predisposition to uveal melanoma remains obscure 4 .…”