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Case Reports
. 2021 Nov 2;17(1):54-59.
doi: 10.1016/j.radcr.2021.09.064. eCollection 2022 Jan.

Uveal melanoma incidentally diagnosed with neuroimaging, a case series of 3 patients

Mai Tsukikawa  1 , Babatunde Akinpelu  2 , Pattana Wangaryattawanich  2 , Kathryn Scherpelz  3 , Andrew W Stacey  1
Affiliations
Case Reports

Uveal melanoma incidentally diagnosed with neuroimaging, a case series of 3 patients

Mai Tsukikawa et al. Radiol Case Rep. .

Erratum in

Abstract

Uveal melanoma is the most common primary intraocular malignancy and can occur in the choroid, the ciliary body, or the iris. It is most often diagnosed based on clinical examination by an ophthalmologist. Nearly all patients present with visual symptoms. Characteristic findings on clinical examination include pigmented or pale choroidal masses with serous retinal detachments and acoustic hollowness seen with ocular ultrasonography. CT and MRI of the orbits are not traditionally utilized for the diagnosis of uveal melanoma. We present 3 cases in which uveal melanoma was an incidental finding on neuroimaging for unrelated conditions in asymptomatic patients. Radiologists should maintain a high suspicion for uveal melanoma when an intraocular mass of greater than 2 mm in thickness is seen on CT or MRI.

Keywords: CT; Choroidal malignant melanoma; MRI.

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Figures

Fig. 1 –
Fig. 1
Patient 1. (A-B) Sagittal T1 weighted image (A) and axial T2 weighted image (B) from brain MRI for an unrelated condition demonstrated an incidental small T1 hyperintense and T2 hypointense mass centered at the superomedial aspect of the left posterior globe (arrows). There was no evidence of extraocular extension or optic nerve involvement. (C) Four years prior to presentation, a choroidal nevus was noted in the superonasal quadrant. (D) At presentation, an elevated, lightly pigmented choroidal lesion was identified in the same location. (E) Eighteen months after completing PBRT, he developed radiation retinopathy and vitreous hemorrhage requiring vitrectomy surgery and laser delivery to the peripheral retina.
Fig. 2 –
Fig. 2
Patient 2. (A-C) Axial T1 weighted image (A), axial T2 weighted image (B), and contrast-enhanced axial T1 weighted image (C) demonstrated a small T1 hyperintense and T2 hypointense enhancing mass centered at the medial aspect of the left posterior globe (arrows). This mass was initially found on head CT which was performed due to altered mental status (not shown). (D) A mushroom-shaped lesion with associated serous retinal detachment was seen in the inferonasal quadrant. (E-F) The subretinal mass was found to be a pigmented, majority epithelioid, choroidal melanoma (H&E stains, original 40x and 400x).
Fig. 3 –
Fig. 3
Patient 3. (A-B) Axial (A) and coronal reformatted (B) contrast-enhanced maxillofacial CT for an unrelated condition showed a mass centered in the inferomedial aspect of the right posterior globe (arrows), measuring 1.4 cm in greatest dimension.
See this image and copyright information in PMC

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