Distant metastasis in choroidal melanoma with spontaneous corneal perforation and intratumoral calcification: A case report

Abstract

BACKGROUNDUveal melanoma is the most common primary intraocular malignancy in adults, but its incidence is low in Asian populations. Spontaneous corneal perforation and intratumoral calcification are rare presentations of choroidal melanoma (CM) , and reports regarding these presentations have been limited. Even after complete surgical treatment, the prognosis of CM patients is usually poor if distant metastasis is present. We here present a case of CM with unique presentations and early distant metastasis to the liver.CASE SUMMARYA 63-year-old Asian woman presented to our hospital with complaint of pain and brownish discharge from her left eye for 3 d. Imaging studies revealed intratumoral calcification within the left eye with eyeball rupture. Enucleation of the left eye was performed and pathological examination confirmed the diagnosis of CM. Systemic surveillance revealed no metastatic diseases. However, the patient was lost to follow-up 3 mo after surgery. At 1.5 years after the operation, she presented to our emergency department with complaint of dull epigastric pain that radiated to the back for 1 d. Imaging studies revealed a large mass at the upper abdomen abutting the pancreatic neck and body as well as several nodular lesions in the liver. Fine needle biopsy was performed and findings confirmed liver and pancreatic metastases.CONCLUSIONThis case highlights the importance of continued follow-up of patients with CM.

TRIP suppresses cell proliferation and invasion in choroidal melanoma via promoting the proteasomal degradation of Twist1

“…At present, CM treatment is primarily based upon radiotherapy or surgical excision or a combination of them. CM patients, however, often suffer from tumor metastasis to distant tissues including liver (90%), lung (24%), and bone (16%) [2]. The median survival of metastatic CM patients is < 1 year [3].…”