Metastasis of a very small choroidal melanoma without apparent clinical change

An unusual case occurred of a very small choroidal melanoma which was clinically inactive for 5 1/2 years, yet developed metastasis. This case appears to be the smallest reported choroidal melanoma with metastatic disease and the first reported metastasis to the anus. The very small size of this choroidal melanoma and its quiescent clinical behavior at the time of the discovery of metastasis, emphasizes the possible danger of observing of small choroidal melanomas.