Aggressive amelanotic choroidal melanoma with extrascleral extension after brachytherapy.
OBJECTIVE
The purpose of this study was to report a case of amelanotic choroidal melanoma, previously treated with brachytherapy, subsequently exhibiting local extension through pars plana vitrectomy sites.


METHODS
The authors present a retrospective interventional case report from a clinical practice.


RESULTS
An amelanotic choroidal melanoma, previously responsive to brachytherapy, underwent two pars plana vitrectomies for nonclearing vitreous hemorrhage with double-freeze cryotherapy to sclerotomy sites. Recurrent melanoma extended through the sclerotomies presenting as subconjunctival nodules requiring exenteration.


CONCLUSIONS
Vitrectomy sclerotomy sites may serve as a route of extrascleral extension in previous brachytherapy treatment-responsive choroidal melanomas. Caution should be exercised in performing vitrectomy for choroidal melanomas with subsequent vitreous hemorrhage.
From the *Department of Ophthalmology, University of Texas Southwestern Medical School, Dallas, Texas; †Texas Retina Associates, Department of Ophthalmology, Presbyterian Hospital, Dallas, Texas.
Carolyn
C
Chen
Karim N
KN
Jamal
Robert Nick
RN
Hogan
Rajiv
R
Anand