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Case Reports
. 2019 Sep 25:16:100557.
doi: 10.1016/j.ajoc.2019.100557. eCollection 2019 Dec.

Necrotic uveal melanoma presenting as orbital cellulitis with intraocular hemorrhage: A case report

Alexa L Li  1 , Julia Y Kang  1 , Duncan E Berry  1 , Krishna B Patel  1 , Andrew M Hendrick  1
Affiliations
Case Reports

Necrotic uveal melanoma presenting as orbital cellulitis with intraocular hemorrhage: A case report

Alexa L Li et al. Am J Ophthalmol Case Rep. .

Abstract

Purpose: To report a case of necrotic uveal melanoma presenting as orbital cellulitis with an intraocular hemorrhage.

Observations: A 61 year-old non-verbal male presented with a two-week history of right eyelid swelling and erythema unresponsive to antibiotics. In addition to these signs of orbital cellulitis, he presented with an opaque media precluding fundus visualization. He was later found to have a collar-button shaped mass consistent with uveal melanoma on B scan ultrasonography during an exam under anesthesia. The patient underwent enucleation with histopathology confirming a necrotic uveal melanoma.

Conclusion and importance: This case demonstrates how necrotic uveal melanoma can present as orbital cellulitis and the importance of keeping the diagnosis on the differential.

Keywords: Necrotic uveal melanoma; Orbital cellulitis.

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Figures

Fig. 1
Fig. 1
An external photograph of the right eye revealed significant upper eyelid edema, erythema, and chemosis.
Fig. 2
Fig. 2
CT of the orbits with contrast showed post-septal fat stranding and a hyperdensity in the vitreous cavity in the right eye.
Fig. 3
Fig. 3
B scan ultrasonography of the right eye revealed a choroidal mass with a collar button-shaped configuration.
Fig. 4
Fig. 4
Cross-section of the globe reveals a 12 mm × 12 mm x 5 mm pigmented mass in the choroid.
Fig. 5
Fig. 5
Higher magnification of the necrotic tumor showed that it was composed of heavily pigmented, spindle shaped cells. (hematoxylin and eosin, 100X).
See this image and copyright information in PMC

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