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[Peripapillary melanoma; 10-year follow-up].
P Fischer1, K Müller-Jensen, H Frenzel
1Augenklinik, Pathologisches Institut, Moltkestr. 90, 76133 Karlsruhe.
Klinische Monatsblatter Fur Augenheilkunde
|February 24, 2001
Summary
Pigmented peripapillary choroidal melanoma can mimic benign lesions like choroidal nevi. Regular eye exams are crucial for early detection and management of these potentially serious tumors.
Area of Science:
- Ophthalmology
- Oncology
Background:
- Choroidal melanomas, particularly in early stages, can be misdiagnosed as benign choroidal nevi or melanocytomas.
- Peripapillary location adds diagnostic challenges due to proximity to the optic nerve head.
Observation:
- A case report details a 41-year-old female initially diagnosed with a choroidal nevus near the optic nerve.
- After a 10-year follow-up lapse, significant tumor growth and serous retinal detachment were observed.
- The patient underwent globe enucleation; subsequent three-year follow-up showed no signs of metastasis.
Findings:
- Histopathological analysis revealed a heavily pigmented peripapillary choroidal melanoma with specific cellular and structural characteristics.
- Immunohistochemical markers (S-100, HMB-45, NSE) confirmed the diagnosis.
- The tumor was classified as pT2, G1, with no scleral or lamina cribrosa infiltration (microscopically RO).
Implications:
- This case underscores the importance of vigilant surveillance for pigmented juxtapapillary lesions that resemble choroidal nevi.
- Annual monitoring is recommended to detect malignant transformation or significant growth of suspicious ocular tumors.
- Timely diagnosis and management of choroidal melanoma are critical for patient outcomes.