Necrotic choroidal melanoma masquerading as scleritis

Putri, Christine Anggun; Salvi, Sachin M.

doi:10.4103/ijo.ijo_271_20

Cited by 6 publications

(5 citation statements)

References 9 publications

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“…In particular, according to Thareja et al, acute pain is the most common clinical finding, being present in all patients of their study [ 53 ]. Moreover, in some case reports and small case series, severe ocular pain was almost always associated with necrotic uveal melanomas [ 11 , 58 ].…”

Section: Discussionmentioning

confidence: 99%

“…In this setting, anterior displacement of the iris diaphragm often occurs, with secondary angle-closure glaucoma and increase in intraocular pressure, furtherly enhancing tumor necrosis that may broaden involving also the iris and ciliary body [ 52 , 53 ]. Then again, the association of necrosis in uveal melanomas, with intraocular inflammation (scleritis, episcleritis, uveitis, and panophthalmitis), secondary angle-closure glaucoma, and increase in intraocular pressure has long been known [ 11 , 51 , 55 , 60 ]. Regardless of which of the two abovementioned hypotheses is the most reliable, the pathogenesis of spontaneous neoplastic necrosis seems to be a complex and multifactorial process.…”

Section: Discussionmentioning

confidence: 99%

“…Almost one-third (30%) of patients with uveal melanoma is asymptomatic and the neoplasm is discovered during a routine eye examination; in the rest of the cases, the lesion can induce blurred vision, visual field defects, photopsia, metamorphopsia, and floaters. In case of tumor necrosis, pain, increased intraocular pressure and inflammatory changes of the sclera, episclera, and uvea may occur [ 5 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Histopathologic and MR Imaging Appearance of Spontaneous and Radiation-Induced Necrosis in Uveal Melanomas: Initial Results

Foti

Inì

Broggi

et al. 2022

Cancers

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Necrosis in uveal melanomas can be spontaneous or induced by radiotherapy. The purpose of our study was to compare the histopathologic and MRI findings of radiation-induced necrosis of a group of proton beam-irradiated uveal melanomas with those of spontaneous necrosis of a control group of patients undergoing primary enucleation. 11 uveal melanomas who had undergone proton beam radiotherapy, MRI and secondary enucleation, and a control group of 15 untreated uveal melanomas who had undergone MRI and primary enucleation were retrospectively identified. Within the irradiated and nonirradiated group, 7 and 6 eyes with histological evidence of necrosis respectively, were furtherly selected for the final analysis; the appearance of necrosis was assessed at histopathologic examination and MRI. Irradiated melanomas showed a higher degree of necrosis as compared with nonirradiated tumors. Irradiated and nonirradiated lesions differed based on the appearance and distribution of necrosis. Irradiated tumors showed large necrotic foci, sharply demarcated from the viable neoplastic tissue; nonirradiated tumors demonstrated small, distinct foci of necrosis. Radiation-induced necrosis, more pigmented than surrounding viable tumor, displayed high signal intensity on T1-weighted and low signal intensity on T2-weighted images. The hemorrhagic/coagulative necrosis, more prevalent in nonirradiated tumors (4 out of 6 vs. 1 out of 7 cases), appeared hyperintense on T2-weighted and hypointense on T1-weighted images. Our study boosts the capability to recognize radiation-induced alterations in uveal melanomas at MRI and may improve the accuracy of radiologists in the evaluation of follow-up MR examination after radiotherapy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Histopathologic and MR Imaging Appearance of Spontaneous and Radiation-Induced Necrosis in Uveal Melanomas: Initial Results

Foti

Inì

Broggi

et al. 2022

Cancers

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“…Melanoma is generally a painless entity, but retinal symptoms of photopsia or blurred vision may occur (10). Melanoma tumor necrosis may lead to pain due to associated episcleritis and scleritis (15,16). Similarly, melanoma is pigmented in approximately 85% cases and lipofuscin deposits are a sign of tumor growth (17).…”

Section: Discussionmentioning

confidence: 99%

Posterior Scleritis Simulating Choroidal Melanoma: Case Report

Khadka¹

2021

Beyoglu Eye J

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A 52-year-old male presented with the complaints of diminution of vision in the left eye (LE) accompanied by mild Nodular posterior scleritis (NPS) is rare; however, it is critical to differentiate it from similar intraocular pathologies to prevent inappropriate and potentially irreversible treatment. Multimodal imaging is beneficial in the diagnosis of NPS. This report describes the diagnosis and management of a case of NPS with corticosteroid therapy that led to complete resolution.

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“…Though largely limited to case reports, neoplastic conditions like choroidal melanoma or undifferentiated carcinoma, conjunctival lymphomas, and ocular surface squamous neoplasia can masquerade as scleritis [186,[189][190][191]. Corticosteroid-resistant scleritis should prompt a scleral biopsy to investigate for neoplasia.…”

Section: Conditions That May Present As Scleritis Masqueradersmentioning

confidence: 99%

Mimickers of anterior uveitis, scleritis and misdiagnoses- tips and tricks for the cornea specialist

Caplash,

Paez-Escamilla,

Westcott

et al. 2024

J Ophthal Inflamm Infect

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Background Anterior uveitis, inflammation of the anterior chamber and related structures, is a cohort of diseases that can present to almost any general or sub-specialty Ophthalmology practice. Its features classically involve anterior chamber cell and flare. Below the surface of these two signs exist a panoply of diagnoses. Body The purpose of this review is to provide a general framework for diagnoses of anterior uveitis that are often missed as well as non-uveitic pathologies that often mimic anterior uveitis. Diagnostic deviation in either direction can have vision-threatening and rarely life-threatening consequences for patients. Using a comprehensive literature review we have collected a broad spectrum of etiologies of anterior uveitis that are easily missed and non-uveitic pathologies that can masquerade as anterior uveitis. Conclusions We present a focused review on specific misdiagnosed anterior uveitis pathologies and some of the conditions that can masquerade as anterior uveitis and scleritis.

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Necrotic choroidal melanoma masquerading as scleritis

Cited by 6 publications

References 9 publications

Histopathologic and MR Imaging Appearance of Spontaneous and Radiation-Induced Necrosis in Uveal Melanomas: Initial Results

Histopathologic and MR Imaging Appearance of Spontaneous and Radiation-Induced Necrosis in Uveal Melanomas: Initial Results

Posterior Scleritis Simulating Choroidal Melanoma: Case Report

Mimickers of anterior uveitis, scleritis and misdiagnoses- tips and tricks for the cornea specialist

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