PMC7700045_01
Deeply pigmented choroidal lesion with a retinal detachment.
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Fundus examination and fluorescein angiography of the left eye showed a retinal detachment (RD) with a large superior brownish mass (Figure 1).
B-scan ultrasonography: large choroidal dome-shaped mass, with neither acoustic hollowing nor calcification, associated with a retinal detachment (subretinal fluid around the mass, without RD extending to the periphery).
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B-scan ultrasonography of the left eye revealed a large choroidal dome-shaped mass, surrounded by subretinal fluid, with neither acoustic hollowing nor calcification (Figure 2).
MRI of the orbits: (a) tumor showing high signal intensity on T1-weighted images; (b) heterogeneous appearance and low signal intensity on T2-weighted images; (c) T2-weighted images on a coronal plane: heterogeneous appearance and low intensity with a collar-button extension (arrow); (d) tumor shows enhancement on T1-weighted images with fat suppression, after Gadolinium administration.
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T1-weighted images after Gadolinium administration. This appearance was consistent with a choroidal melanoma. There was a scleral thickening and no evidence of extraocular tumor extension (Figure 3). Thoracoabdominal CT scan did not reveal any sign of metastasis.
Pathologic findings: (a) pigmented tumor composed of fusiform cells with brownish cytoplasm (hematoxylin-eosin stain, original magnification 10x). Two different zones: (b) the first one is highly pigmented with brownish cytoplasm, and (c) the second zone is less pigmented where we can see the nuclear details: fusiform cells with elongated nuclei and small nucleoli, without necrosis, atypia, or mitotic activity (hematoxylin-eosin stain, original magnification 40x).
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No signs of necrosis or malignancy were found (Figure 4).