Choroidal melanoma with massive lipid exudation in a patient with metastatic hypernephroma

A 75-year-old woman with diffuse metastatic hypernephroma had a unilateral total exudative retinal detachment associated with a big choroidal mass. In addition, multiple yellow-white intra- and subretinal deposits were seen around the tumor. These findings and the patient's medical history led us to think of choroidal metastatic hypernephroma with intraocular spread. However, histopathologic examination revealed the presence of epithelioid malignant melanoma of the choroid with numerous retinal and subretinal lipid deposits and lipid-laden macrophages. This picture of massive lipid exudation is rare in untreated choroidal melanomas.