Choroidal melanoma

Case contributed by Ammar Haouimi
Diagnosis probable

Presentation

Bilateral microphthalmia with decreased visual acuity.

Patient Data

Age: 60 years
Gender: Female
ultrasound
Download
Info

The ultrasound demonstrates:

  • small echogenic focus within the surface of the optic nerve head bilaterally with posterior acoustic shadowing in keeping with optic disc drusen 
  • small echogenic intraocular mass with internal vascularity
mri
This study is a stack
Sagittal
T1
This study is a stack
Axial
FLAIR
This study is a stack
Coronal
T2
This study is a stack
Axial
Gradient Echo
This study is a stack
Axial T2
fat sat
This study is a stack
Coronal T2
fat sat
This study is a stack
Axial T1
fat sat
This study is a stack
Axial T1
C+ fat sat
This study is a stack
Coronal T1
C+ fat sat
This study is a stack
Coronal
T1 C+
This study is a stack
Axial
T1 C+
This study is a stack
Axial
DWI
This study is a stack
Axial
ADC
Download
Info

The MRI sequences demonstrate:

  • bilateral microphthalmia
  • optochiasmatic atrophy
  • small right intraocular soft tissue mass at the inferonasal quadrant measuring (7 x 5 x 4 mm) of high signal on T1, low signal on T2 with vivid homogeneous enhancement on postcontrast sequences. No extraocular extension is seen. 
  • smooth scleral thickening with enhancement choroidal/retinal enhancement

Small vessel chronic ischemic changes are noted.

Case Discussion

MRI features are suggestive of choroidal melanoma in a patient with bilateral microphthalmia with optochiasmatic atrophy. The optic disc drusen was probably an incidental finding.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

:

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.