Advanced choroidal melanoma with a desirable aesthetic outcome after enucleation: A case report

Abstract

Choroidal melanoma is a rare ocular tumor. The present study reports the case of a 66-year-old male who presented with chronic headache and progressive visual loss. Physical eye examination and combined A- and B-mode ultrasonography detected choroidal melanoma. Due to tumor characteristics the eye was enucleated restoring the orbital volume with a 22 mm intraorbital bioceramic sphere implant. The eye was subjected to histopathological examination that confirmed the choroidal melanoma, 2 cm in diameter and 0.8 cm in elevation, occupying almost half of the globe. Microscopically, the neoplasm comprises mostly of epithelioid cells and fewer Type B spindle cells, with intense pigmentation. AJCC staging for the melanoma was T4b. The patient was fitted with an artificial eye after enucleation. Thirteen months after initial diagnosis, liver metastases were confirmed during his scheduled follow-up.

Keywords: choroidal; enucleation; eye; melanoma; ocular.

Figure 1.

Mesh-wrapped bioceramic implant, used to restore the volume of the orbit.

Figure 2.

Choroidal melanoma. Grey arrow indicates ciliary body; red arrow shows infiltration of radial portion of ciliary body; black arrow shows the melanoma.

Figure 3.

Choroidal melanoma near the optic nerve. Black arrow shows tumor near the optic nerve without infiltrating it; red arrow indicates the retina; white arrow indicates intense pigmentation.