Title

CHOROIDAL EPITHELIOID MELANOMA: A CASE REPORT

Introduction

A 58-year-old male patient reported low visual acuity (VA) in the right eye (RE) for 2 months. He denied eye surgery, comorbidities and medications for continuous use. On ophthalmological examination, he presented VA of 30cm finger count and biomicroscopy without alteration. At funduscopy of the RE, an inferior temporal subretinal cupuliform lesion was identified, with retinal detachment, with no signs of rupture.

Methods

An ultrasonography (USG) of the RE was then performed, in which a mushroom-like lesion was identified, with intrinsic vascularity and medium reflectivity, in a lower temporal topography, with Kappa angle present. The lateral-lateral diameter of its base measured 9.83 mm and its height was 9.93 mm.

Results

CTs of the abdomen, skull and thorax and dermatological evaluation for possible melanocytic lesions were requested. The screening performed showed no sign of metastasis or primary extraocular tumor. As treatment, the patient was offered two options: Iodine 125 brachytherapy and enucleation. After talking with the family, the patient opted for enucleation, and the histopathological study showed epithelioid choroidal melanoma without extraocular extension.

Discussion

The case presented demonstrates the importance of performing ocular USG in all cases of detachments of the serous retina, since the accurate differential diagnosis helps in the early implementation of therapy. Elements of the doctor-patient relationship, such as correct communication and shared decision, are also important for the management of the case.

Keywords

choroidal melanoma; serous retinal detachment; ocular oncology

Area

CLINICAL CASE

Authors

ADRIANO CABRAL DE VASCONCELOS, FABIANA KARLA AQUINO DA COSTA, LUCAS MUNIZ SUASSUNA DE MEDEIROS, TIAGO CAVACALCANTI, BRUNO PACHU RAIA DOS SANTOS, CECILIA MENELAU CAVALCANTI