case_images: PMC11733111_01
case_images: Multimodal clinical imaging of the case described.. A Optos widefield fundal imaging at initial presentation with acute red eye. B Optos widefield fundal imaging three months after presentation following treatment with topical steroids. There was no regression in the choroidal lesion and subtle growth at the superior edge. C B-mode ultrasound of the choroidal mass at presentation, 2.1 mm (height) x 11.7 mm (longitudinal base) x 14.3 mm (transverse base), with low to medium echogenicity. There was a possible, slow internal blood flow as the recorded velocity in one vessel was 1.8 cm/s. D Histopathology of the specimen from the trans-vitreal biopsy of the right choroid which included tiny clumps of atypical cells. E Histopathology specimen obtained by Trans-scleral Essen Forceps biopsy (TSEB) of the right eye, stained with H & E at low magnification. This shows fibroconnective tissue with scattered melanin and an infiltrate of atypical cells with hyperchromatic nuclei, confirming malignant choroidal melanoma.
case_images: 41433_2024_3394_Fig2_HTML.jpg
case_images: PMC11733111_01_41433_2024_3394_Fig2_HTML.jpg
case_images: Fig2
case_images: Dilated fundoscopy of the right eye showed an inferior shallow exudative retinal detachment, with an associated predominately amelanotic, irregularly shaped choroidal mass in the inferotemporal quadrant, without orange pigment, exudation or visible intralesional vessels (Fig. 2A). B-scan ultrasound (US) confirmed a shallow choroidal mass, 2.1 mm in thickness, with a base of 11.7 mm x 14.3 mm, with low to medium echogenicity (Fig. 2C). However, dilated fundoscopy three months after presentation showed the choroidal lesion had not regressed (Fig. 2B). Immunohistochemistry for AE1/AE3, CD3 and CD79a were also negative, rendering carcinoma and lymphoma unlikely (Fig. 2D).