Disappearance of ocular malignant melanoma on computerised scan after spontaneous necrosis: clinical, radiological...

An 82 year old patient was lost to follow-up having been diagnosed both clinically and on CT scan as having a right choroidal malignant melanoma. Twenty months later she presented with a painful right proptosis, dense cataract and raised intraocular pressure. A second CT scan showed orbital cellulitis with no evidence of the previous mass. Following enucleation histopathological examination revealed that the tumour had undergone total spontaneous necrosis. The implications of the CT scan findings are discussed. Five cases of necrosed choroidal malignant melanoma producing proptosis in the absence of extrascleral tumour extension have now been described.