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Massively invasive diffuse choroidal melanoma.

J W Sassani, J M Weinstein, W P Graham

Archives of Ophthalmology (Chicago, Ill. : 1960)

|July 1, 1985

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Malignant melanoma of the eye can spread to the brain, even without neurological symptoms. Cerebrospinal fluid cytology is crucial for detecting this rare but serious complication.

Area of Science:

Ophthalmology
Oncology
Neurology

Background:

Uveal malignant melanoma is the most common primary intraocular malignancy.
Orbital involvement can occur, necessitating aggressive treatment.

Observation:

A 74-year-old woman presented with proptosis and neovascular glaucoma in a blind left eye.
Diagnosis was uveal malignant melanoma with extensive orbital invasion.

Findings:

The tumor involved the optic nerve and sheath.
Cerebrospinal fluid cytology revealed metastatic melanoma, despite no neurological signs.
Ultrasonography proved valuable in diagnosis.

Implications:

Cerebrospinal fluid cytology is essential for diagnosing occult central nervous system metastasis in uveal melanoma.

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Early detection through cytology and imaging can guide treatment strategies.

This case highlights the importance of considering systemic spread even in the absence of overt neurological symptoms.