Massively invasive diffuse choroidal melanoma
J. W. Sassani, J. M. Weinstein and W. P. Graham
A 74-year-old woman was found to have increasing proptosis in a blind,
painful left eye with neovascular glaucoma. Uveal malignant melanoma with
massive orbital involvement was diagnosed, and the patient underwent
orbital exenteration, with preoperative and postoperative orbital
irradiation. The tumor was a mixed-cell, diffuse uveal malignant melanoma
with involvement of the optic nerve adjacent to the line of surgical
transection and of the optic nerve sheath. Subsequently, the cerebrospinal
fluid cytology disclosed cells consistent with malignant melanoma, despite
the absence of neurologic signs or symptoms. Cerebrospinal fluid cytology
is essential in such cases, and ultrasonography is of value.
