Choroidal melanoma appearing as vitreous hemorrhage

A 63-year-old woman had a spontaneous vitreous hemorrhage in her right eye that precluded adequate visualization of the posterior segment. Initial ultrasonic examination disclosed findings compatible with vitreous hemorrhage, hemorrhagic retinal detachment, and choroidal elevation. A second ultrasonic examination two months later showed findings compatible with choroidal melanoma, which was confirmed on histopathologic examination of the enucleated eye. Large vascular tumor channels, intratumor scar tissue, irregular tumor surface contour, and focal proliferation of retinal pigment epithelium confirmed the site of the hemorrhage, which had extended into the vitreous cavity.