Melanoma-Associated Spongiform Scleropathy Adjacent to a Choroidal Nevus

Abstract

Melanoma-associated spongiform scleropathy contiguous to a choroidal nevus was an incidental finding in a 57-year-old woman whose eye was removed for a separate choroidal-ciliary body melanoma. All previously reported cases of melanoma-associated spongiform scleropathy, except for one, have been found adjacent to posterior uveal melanoma. The mechanism of scleral degeneration in melanoma-associated spongiform scleropathy is unknown. Few cases of posterior uveal nevi have been reported since the description of spongiform scleropathy, making assessment of the specificity of the degeneration to melanoma alone difficult. The presence of melanoma-associated scleropathy adjacent to a choroidal nevus indicates that the condition is not exclusively linked to posterior uveal melanoma.

Keywords: Choroidal nevus; Melanoma-associated spongiform scleropathy; Nevus; Scleral degeneration.

Fig. 1

A 6 × 4.5 mm oval hypopigmented lesion is present temporal to the right macula. A large choroidal-ciliary body melanoma creates the crescentic shadow nasally.

Fig. 2

A large dome-shaped melanoma of the choroid and ciliary body is present nasally (hematoxylin-eosin; scale bar, 2.7 mm). Inset The sclera contiguous to the melanoma is normal (hematoxylin-eosin; scale bar, 350 μm).

Fig. 3

The upper panel shows the macular nevus composed of spindle-shaped nuclei with bland vesicular chromatin. The sclera contiguous to the nevus appears pale relative to the outer sclera (hematoxylin-eosin; scale bar, 100 μm). The lower panel shows the nevus in higher magnification. The collagen fibers of the inner sclera are fragmented and splayed apart (hematoxylin-eosin; scale bar, 300 μm).

Fig. 4

Alcian blue stain above and periodic acid-Schiff (PAS) below shows diminished stain intensity in the sclera adjacent to the choroidal nevus (scale bar, 180 μm).