Bilateral Choroidal Metastases from Primary Esophageal Melanoma

Abstract

The purpose of this case report is to report a rare, bilateral, choroidal metastases from a primary esophageal melanoma. A 44-year-old white female presented to the ocular oncology clinic in February 2010 on urgent referral from her ophthalmologist for evaluation of an elevated mass in each eye. The patient presented with best-corrected visual acuities of 20/25 in both eyes. Fundus examination displayed creamy white choroidal infiltrates located in the superior temporal arcade of the right eye and temporally in the left eye. The patient was diagnosed with bilateral choroidal metastatic melanoma from known primary esophageal melanoma. External beam radiation therapy was administered and complete resolution of the lesions occurred. Final visual outcome was 20/20 in both eyes. Nine months after diagnosis of choroidal metastases, the patient died from complications related to the extensive systemic metastatic involvement. Choroidal metastases are the most common intraocular malignancy. However, metastatic melanoma is a rare finding and has only been reported from cutaneous and primary choroidal melanoma. Therefore, to the best of the authors' knowledge, this is the first reported case of bilateral choroidal metastasis from a primary esophageal malignant melanoma.