Epibulbar foreign body granuloma masquerading as extrascleral extension following brachytherapy for choroidal melanoma.
OBJECTIVE
To describe a patient with epibulbar foreign body granuloma following brachytherapy for choroidal melanoma and to illustrate the echographic features that aided in the differential diagnosis.


METHODS
Observational case report. Patient had multiple clinical exams over time to evaluate a treated choroidal melanoma.


METHODS
A 61-year-old man presented for echographic follow-up examination following treatment for choroidal melanoma. An epibulbar lesion was noted adjacent to the site of the previously treated choroidal melanoma. Incisional biopsy and histologic evaluation were required.


RESULTS
Ultrasonography revealed regression of the intraocular tumor; however, an oval epibulbar mass with irregular internal structure, irregular reflectivity, and no vascularity was noted. The echographic features were not typical of extrascleral extension of choroidal melanoma. Histopathologic evaluation showed fibrous connective tissue with an intense infiltrate of histiocytes with occasional giant cells and rare birefringent foreign body materials.


CONCLUSIONS
Foreign body granuloma should be considered in the echographic differential diagnosis of an atypical extrascleral lesion following uveal melanoma brachytherapy.
From Wilmer Ophthalmological Institute, Johns Hopkins University, Baltimore, Maryland.
Bernadete
B
Ayres
Nicholas
N
Iliff
W Richard
WR
Green
James T
JT
Handa
Cathy W
CW
DiBernardo