PMC5298927_01
Fundus photograph, B-scan ultrasonography, and fluorescein angiography. A, Fundus photograph of the left eye shows ciliochoroidal melanoma remote from the optic nerve. B, B-scan ultrasonography of the left eye reveals a choroidal mass remote from the optic nerve and inferior retinal detachment. C, Late fluorescein angiographic image reveals no leakage from the right eye. D, Late fluorescein angiographic image shows optic disc leakage from the left eye.
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F1
The tumor measured greater than 18x16.3x9.15 mm, with ciliary body involvement (AJCC stage T4b) and low internal reflectivity by ultrasonography (Figure 1). Angiographic findings were unremarkable in the right eye but showed hyperfluorescent spots with late tumor leakage in the left eye (Figure 1).
Magnetic resonance image and histopathologic analysis. A, Axial T1-weighted magnetic resonance image demonstrates that the ciliochoroidal tumor of the left globe is remote from the optic nerve. Inset, Transverse section of the left optic nerve (from the area of the box in the magnetic resonance image) with no evidence of tumor invasion (original magnification x200). B, Ciliochoroidal melanoma (hematoxylin-eosin, original magnification x100). Inset, Epithelioid cells (hematoxylin-eosin, original magnification x400).
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F2
Microscopically, the ciliochoroidal tumor showed spindle and epithelioid cells, consistent with melanoma (Figure 2). No tumor cells were found in, on, or around the optic nerve; specifically, there was no sign of tumor encroaching on the lamina choroidalis (Figure 2 and eFigure, http://www.jamaophth.com).