Skip to main content
Journal cover image

Endoscopic enucleation and clinicopathologic correlation of a small choroidal melanoma hiding massive extrascleral extension.

Publication ,  Journal Article
Yu, MD; Chiang, B; Pasricha, MV; Erickson, BP; Mruthyunjaya, P
Published in: Am J Ophthalmol Case Rep
March 2023

PURPOSE: To report the unusual case of a previously stable choroidal nevus, closely followed for over 15 years, which underwent malignant transformation into small choroidal melanoma with massive extrascleral extension. OBSERVATIONS: A 67-year-old Caucasian female was referred to the Stanford Ocular Oncology Service with concern for malignant transformation of a previously stable choroidal nevus in her left eye. Her funduscopic examination demonstrated a dome-shaped choroidal lesion with overlying associated lipofuscin and subretinal fluid, consistent with a diagnosis of small choroidal melanoma. By B-scan ultrasonography, the lesion measured 8.0 × 6.0 mm in base and 2.1 mm in thickness. B-scan ultrasonography also disclosed an associated retroscleral mass, which appeared contiguous with the intraocular melanoma and was confirmed on subsequent orbital magnetic resonance imaging. A decision was made to proceed with enucleation. Under direct endoscopic visualization, the globe and extrascleral mass were fully isolated, mobilized, and removed in toto. At 24 months post-enucleation, the patient remains disease-free without evidence of systemic metastasis or local recurrence. CONCLUSIONS/IMPORTANCE: This case describes a small choroidal melanoma hiding massive extrascleral extension, underscoring the value of B-scan ultrasonography. This case also describes the unique management of choroidal melanoma with extrascleral extension using endoscopic enucleation. Performing enucleation under direct endoscopic visualization ensures complete resection and prevents inadvertent transection of the extrascleral component.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Am J Ophthalmol Case Rep

DOI

EISSN

2451-9936

Publication Date

March 2023

Volume

29

Start / End Page

101797

Location

United States
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Yu, M. D., Chiang, B., Pasricha, M. V., Erickson, B. P., & Mruthyunjaya, P. (2023). Endoscopic enucleation and clinicopathologic correlation of a small choroidal melanoma hiding massive extrascleral extension. Am J Ophthalmol Case Rep, 29, 101797. https://doi.org/10.1016/j.ajoc.2023.101797
Yu, Michael D., Bryce Chiang, Malini Veerappan Pasricha, Benjamin P. Erickson, and Prithvi Mruthyunjaya. “Endoscopic enucleation and clinicopathologic correlation of a small choroidal melanoma hiding massive extrascleral extension.Am J Ophthalmol Case Rep 29 (March 2023): 101797. https://doi.org/10.1016/j.ajoc.2023.101797.
Yu MD, Chiang B, Pasricha MV, Erickson BP, Mruthyunjaya P. Endoscopic enucleation and clinicopathologic correlation of a small choroidal melanoma hiding massive extrascleral extension. Am J Ophthalmol Case Rep. 2023 Mar;29:101797.
Yu, Michael D., et al. “Endoscopic enucleation and clinicopathologic correlation of a small choroidal melanoma hiding massive extrascleral extension.Am J Ophthalmol Case Rep, vol. 29, Mar. 2023, p. 101797. Pubmed, doi:10.1016/j.ajoc.2023.101797.
Yu MD, Chiang B, Pasricha MV, Erickson BP, Mruthyunjaya P. Endoscopic enucleation and clinicopathologic correlation of a small choroidal melanoma hiding massive extrascleral extension. Am J Ophthalmol Case Rep. 2023 Mar;29:101797.
Journal cover image

Published In

Am J Ophthalmol Case Rep

DOI

EISSN

2451-9936

Publication Date

March 2023

Volume

29

Start / End Page

101797

Location

United States