Choroidal melanoma masquerading as panuveitis in a patient with multiple myeloma.
BACKGROUND
Choroidal melanoma can sometimes present with associated anterior uveitis or panuveitis that can mask the underlying intraocular neoplasm and confound the diagnosis.


METHODS
Retrospective chart review.


RESULTS
A 58-year-old woman presented with recurrent episodes of hypopyon, severe panuveitis, and a choroidal mass lesion in the right eye. Extensive systemic workup led to a diagnosis of multiple myeloma. Despite successful treatment of myeloma, the choroidal mass persisted and increased in size. Transscleral biopsy of the mass lesion revealed primary malignant choroidal melanoma.


CONCLUSIONS
This case demonstrates that choroidal melanoma can present as masquerade syndrome with significant intraocular inflammation. Such cases pose a significant diagnostic dilemma to the clinician. Transscleral choroidal biopsy can provide critical information that is essential to establishing a definitive diagnosis and treatment plan.
From *Valley Retina Institute, P.A., McAllen, Texas; †the Department of Pathology, The Methodist Hospital, Houston, Texas; and ‡The University of Texas M.D. Anderson Cancer Center, Houston, Texas.
Vincent R
VR
Vann
Gian P
GP
Giuliari
Rodolfo M
RM
Banda
Patricia
P
Chévez-Barrios
Gregory N
GN
Fuller
Dan S
DS
Gombos