Aggressive amelanotic choroidal melanoma with extrascleral extension after brachytherapy

Retin Cases Brief Rep. 2011 Winter;5(1):37-41. doi: 10.1097/ICB.0b013e3181c3339b.

Abstract

Purpose: The purpose of this study was to report a case of amelanotic choroidal melanoma, previously treated with brachytherapy, subsequently exhibiting local extension through pars plana vitrectomy sites.

Method: The authors present a retrospective interventional case report from a clinical practice.

Results: An amelanotic choroidal melanoma, previously responsive to brachytherapy, underwent two pars plana vitrectomies for nonclearing vitreous hemorrhage with double-freeze cryotherapy to sclerotomy sites. Recurrent melanoma extended through the sclerotomies presenting as subconjunctival nodules requiring exenteration.

Conclusion: Vitrectomy sclerotomy sites may serve as a route of extrascleral extension in previous brachytherapy treatment-responsive choroidal melanomas. Caution should be exercised in performing vitrectomy for choroidal melanomas with subsequent vitreous hemorrhage.