A Case of Uveal Melanoma Masquerading as Choroidal Lymphoma.

Q3 Medicine Retinal Cases and Brief Reports Pub Date : 2025-02-14 DOI:10.1097/ICB.0000000000001738

Saleh Sahal H, Stepanian Rima, Juliano Joseph D, Folberg Robert, Laurie Lau-Sickon, Faia Lisa J, Weiner Adam J

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Abstract

Purpose: To present a case of uveal melanoma masquerading as choroidal lymphoma.

Methods: A retrospective case report in which medical and imaging records, including fundus photography, optical coherence tomography, fundus autofluorescence, fluorescein angiography, and ultrasonography were reviewed.

Results: A 77-year-old woman presented with decreased vision was found to have a diffuse, shallow, yellow choroidal mass associated with RPE pigmentary changes and exudative detachment in her right eye. Multi-modal imaging demonstrated thickened choroid with a "lumpy-bumpy" appearance on OCT, "leopard-spotting" on fundus autofluorescence, and a shallow "table-top" configuration on B scan. Systemic workup was unremarkable. The patient elected to undergo treatment with low-dose external beam radiation for presumed choroidal lymphoma. There was no response to radiation prompting retinochoroidal biopsy, which revealed spindle-cell uveal melanoma and resulted in enucleation.

Conclusion: We present a case of uveal melanoma masquerading as choroidal lymphoma. This case highlights that uveal melanoma can rarely masquerade as other entities, including uveal lymphoma.

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葡萄膜黑色素瘤伪装成脉络膜淋巴瘤1例。

目的：报告一例葡萄膜黑色素瘤伪装成脉络膜淋巴瘤。方法：回顾性分析眼底摄影、光学相干断层扫描、眼底自体荧光、荧光素血管造影和超声检查等医学和影像学资料。结果：一名77岁女性因视力下降，右眼发现弥漫性浅黄色脉络膜肿块，并伴有RPE色素改变和渗出性脱离。多模态成像显示OCT上脉络膜增厚，呈“块状-凹凸不平”样，眼底自身荧光显示“豹纹斑点”，B扫描显示浅“桌面”状。系统的检查并不显著。患者选择接受低剂量外束辐射治疗脉络膜淋巴瘤。放疗提示视网膜脉络膜活检无反应，显示梭状细胞葡萄膜黑色素瘤并导致去核。结论：我们报告一例葡萄膜黑色素瘤伪装成脉络膜淋巴瘤。这个病例强调了葡萄膜黑色素瘤很少能伪装成其他实体，包括葡萄膜淋巴瘤。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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