Resection of uveal melanocytoma: clinicopathological correlation

Four patients had pigmented lesions in the anterior uveal tract and choroid which presented clinically as malignant melanomas. All the lesions were successfully removed by local excision. Histopathological studies showed the tumours to be melanocytomas, indicating that enucleation or irradiation would have been contraindicated. The 3 patients with iris and ciliary body melanocytomas continue to maintain corrected visual acuities of 20/30 or better. In the patient with choroidal melanocytoma central visual acuity was compromised owing to cystoid macular oedema. All 3 melanocytomas involving the anterior segment were located inferiorly. Biomicroscopically, they were chocolate coloured (not black) and resembled malignant melanomas of the same location. The choroidal melanocytoma also resembled a malignant melanoma by ophthalmoscopic and angiographic criteria, and did not have the jet black or homogeneous pigmentation that characterises most melanocytomas of the disc.