Cataract Obscuring a Large Primary Choroidal Melanoma and Associated Exudative Retinal Detachment in the Left Eye: A Case Report

Abstract

Choroidal melanoma is the most common primary malignant intraocular tumor that rarely is left undiagnosed. We report a case of a lately detected choroidal melanoma associated with exudative retinal detachment and severe visual loss in the affected eye. The patient was referred to our clinic with visual acuity in the right eye 6/6 while in the left eye was limited to light perception. Ophthalmic examination showed a large pigmented choroidal tumoral mass occupying most of the vitreous cavity and associated exudative retinal detachment. Ultrasonography confirmed a dome-shaped tumor with internal homogeneity, while anterior choroid, ciliary body and angle were found with no invasion. The fellow eye was examined thoroughly and no lesions were detected. Further clinical investigation for metastasis was negative. Negligence of the symptoms, gradual evolution of the tumor and late referral resulted in irreversible loss of vision. The patient had no other systemic pathology and was advised for enucleation in the left eye and follow-up. Choroidal melanoma is a serious malignancy that could threaten the patient’s life and requires early detection and treatment. In large lesions enucleation is the treatment of choice. J Med Cases. 2015;6(1):10-13 doi: http://dx.doi.org/10.14740/jmc2004w