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TitreAn aggressive small choroidal melanoma or How optic disc swelling helped to suspect extraocular invasion.
Abstract Nr.1068
ButTo describe a small non diffuse choroidal melanoma with extraocular extension.
MéthodesA Case-report
RésultatsWe describe the case of a 50year-old patient presenting with visual loss and metamorphopsia. Fundus examination revealed a suprapapillary trilobular choroidal mass with inhomogenous pigmentation and lipofuscin. The optic nerve was slightly oedematous. On fluorescein angiography, the lesion revealed pin-points and exsudation. Ultrasound sonography (20Mhz) showed a peripapillary lesion of 3mm thickness. MRI was performed and confirmed the diagnosis of choroidal melanoma. No extraocular extension was seen on MRI or ultrasound imaging. Because of optic nerve oedema we decided to perform an enucleation. On pathology, the lesion measured 9mm diameter and 3mm thickness. It was mostly composed of epithelioïd cells and it showed scleral, perineural , optic nerve and periocular soft tissue invasion. Complementary orbital radiotherapy was performed. Until now, after one year follow-up, the patient has shown no metastasis or local recurrence.
ConclusionExtraocular invasion in a small thickness non diffuse choroidal melanoma is rare. In times of eye-sparing choroidal melanoma treatment, the ophthalmologist should not forget the possibility of extra-ocular involvement, even in small tumors.
Auteur 1
NomLAUWERS
InitialesN.
InstitutUZA- Oogheelkunde
VilleEdegem
Auteur 2
NomDE GROOT
InitialesV.
InstitutUZA- Oogheelkunde
VilleEdegem
Auteur 3
NomSiozopulou
InitialesV.
InstitutUZA- Pathologische anatomie
VilleEdegem
Auteur 4
NomDe Keizer
InitialesRJW
InstitutUZA- Oogheelkunde
VilleEdegem
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