Choroidal Melanoma: Screening for metastasis and frequency of incidental second primary cancer diagnosis.

Ethan Leyda OD, The Ohio State University College of Optometry, Cleveland Veterans Affairs Medical CenterFollow

Medical Subject Headings

Delayed Diagnosis; Neoplasms, Second Primary; Citrus sinensis; Choroid Neoplasms; Uveal melanoma

Abstract

Background: Choroidal melanoma is the most common primary intraocular malignancy in adults. This case report reviews clinical diagnostic features, imaging techniques, treatment, prognosis, and systemic work-up of choroidal melanomas. It also addresses choroidal melanoma metastasis and the incidental finding of second primary cancers through whole-body screening.

Case Report: A 71-year-old white male reported to the Cleveland VA Medical Center optometry retina clinic for a second opinion exam of an asymptomatic choroidal lesion in the right eye. The lesion was a 6 mm gray choroidal mass in the inferior peripheral fundus, with orange pigmentation, retinal pigmented epithelial hypertrophy along the superior border, and drusen. B-scan ultrasound showed a mass that was elevated by 2.5 mm with moderate reflectivity, suggestive of choroidal melanoma.

Conclusion: Early diagnosis of choroidal melanoma is important due to improved survival rates in those diagnosed when the choroidal melanoma is small. In addition to the clinical assessment, diagnosis may be aided by ancillary imaging such as OCT. Prognosis generally is poor due to late diagnosis and is dependent on choroidal melanoma size, genetic profile, and presence of metastasis. Whole-body screening for metastasis leads to the discovery of additional primary tumors at a rate nearly equal to that of metastasis.

Recommended Citation

Leyda E. Choroidal Melanoma: Screening for metastasis and frequency of incidental second primary cancer diagnosis.. Optometric Clinical Practice. 2021; 3(2):19. https://doi.org/10.37685/uiwlibraries.2575-7717.3.2.1023