Choroidal melanoma

Case contributed by Dr Ammar Haouimi

Presentation

Bilateral microphthalmia with decreased visual acuity.

Patient Data

Age: 60 years
Gender: Female
Ultrasound

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

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.

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Case information

rID: 89263
Published: 4th May 2021
Last edited: 6th May 2021
Inclusion in quiz mode: Included
Institution: Aurès Medical Imaging Center - Batna Algeria