title: Intraocular malignant melanoma of the choroid presenting as orbital cellulitis.
abstract: We report a case of choroidal melanoma with features suggestive of orbital cellulitis. A 24-year-old Asian Indian male presented with a 20-day history of sudden loss of vision in the right eye. Edematous eyelids with complete mechanical ptosis, complete ophthalmoplegia, gross proptosis accompanied by massive chemosis, and prolapse of the inferior forniceal conjunctiva were noted. He denied perception of light in the right eye. The left eye was unremarkable. B-scan ultrasonography of the right eye showed a large dome-shaped mass filling the posterior segment suggestive of choroidal melanoma. Computed tomography confirmed those findings and showed no extraocular tumor extension. The patient was conservatively treated with systemic steroids following which the inflammation subsided. He underwent enucleation of the right eye and a diagnosis of spindle A cell choroidal melanoma was confirmed by histopathological examination. Although rare, orbital cellulitis is one of the presenting features of choroidal melanoma. Uveal melanoma-associated orbital cellulitis can be well controlled with systemic steroids, does not always indicate extraocular tumor extension, and can occur in spindle A cell melanomas.
authors.affiliation: Ophthalmic Plastic Surgery and Ocular Oncology Services, L V Prasad Eye Institute, Road Number 2, Banjara Hills, Hyderabad, 500034, India.
authors.forename: Akshay Gopinathan
authors.initials: AG
authors.lastname: Nair
authors.forename: Swathi
authors.initials: S
authors.lastname: Kaliki
authors.forename: Mohammed Javed
authors.initials: MJ
authors.lastname: Ali
authors.forename: Milind N
authors.initials: MN
authors.lastname: Naik
authors.forename: Geeta K
authors.initials: GK
authors.lastname: Vemuganti
mesh_terms: D002830:Choroid Neoplasms / Q000150:complications* / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008545:Melanoma / Q000150:complications* / Q000473:pathology; D054517:Orbital Cellulitis / Q000175:diagnosis / Q000209:etiology*; D055815:Young Adult
references.citation: Ann Ophthalmol. 1992 May;24(5):190-4
references.pmid: 1637129
references.citation: Graefes Arch Clin Exp Ophthalmol. 1982;219(1):40-3
references.pmid: 7117860
references.citation: Ophthalmic Plast Reconstr Surg. 1998 Jul;14(4):286-9
references.pmid: 9700739
references.citation: Orbit. 1999 Jun;18(2):123-130
references.pmid: 12045997
references.citation: Am J Ophthalmol. 1998 Jun;125(6):745-66
references.pmid: 9645714