Malignant transformation of a necrotic melanocytoma of the choroid in an amblyopic eye.
A 26-year-old man presented with an insidious loss of vision OD. He had amblyopia OD as a child secondary to congenital esotropia. Ophthalmic examination revealed a large mass beneath his right retina near the posterior pole. He also had glaucoma and a rapidly developing cataract. Ultrasound detected a choroidal mass, which was consistent with a melanoma. The patient chose enucleation over radiation therapy as his treatment modality. Pathologic evaluation of the tumor revealed a necrotic melanocytoma with a large malignant melanoma arising from its center that was comprised mainly of epithelioid cells. Malignant melanoma arising in a necrotic melanocytoma is an extremely rare event, and we believe this to be the first description of this event in a young patient with an amblyopic eye.
Intermountain Ocular Research Center, Department of Ophthalmology, University of Utah, Salt Lake City.
M
M
Leidenix
N
N
Mamalis
R
R
Goodart
R
R
Harrie
C
C
Kjeldsberg
D000328:Adult; D000550:Amblyopia / Q000209:etiology*; D002471:Cell Transformation, Neoplastic / Q000473:pathology*; D002830:Choroid Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D004948:Esotropia / Q000150:complications / Q000151:congenital; D015353:Eye Enucleation; D006801:Humans; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging / Q000473:pathology*; D009508:Nevus, Pigmented / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography