Hemorrhagic complication in an unsuspected macular choroidal melanoma.
OBJECTIVE
To report a rare presentation of a hemorrhagic complication in a patient with unsuspected macular choroidal melanoma.


METHODS
Interventional case report.


METHODS
A 32-year-old Chinese woman presented with disturbance of her left central vision. A hemorrhagic mass at the macula was noticed that was evacuated by submacular surgery.


RESULTS
The mass expanded rapidly into a mushroom configuration after surgery. Fine-needle aspiration confirmed the diagnosis of malignant choroidal melanoma, and enucleation followed. Histology demonstrated moderately large epithelioid tumor cells with prominent nucleoli. The sclera was intact, and the optic nerve was not involved. The patient has been followed for 5 years without signs of local recurrence or metastasis.


CONCLUSIONS
We should be alert for atypical presentations of choroidal melanoma. Unnecessary or inadvertent surgical intervention may induce tumor growth and subsequent local spread or metastasis.
Chan
Wai-Man
WM
Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong. cwm6373@netvigator.com
Kwok
Alvin K H
AK
Liu
David T L
DT
Choi
Paul C L
PC
Lam
Sze-Wing
SW
Lam
Dennis S C
DS
D000328:Adult; D002830:Choroid Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery; D015353:Eye Enucleation; D005260:Female; D006801:Humans; D008545:Melanoma / Q000150:complications* / Q000473:pathology / Q000601:surgery; D012166:Retinal Hemorrhage / Q000209:etiology* / Q000601:surgery