Advanced ring melanoma of the choroid and ciliary body with extrascleral extension

Abstract

Introduction: Ring melanoma is a rare form of uveal melanomas that is characterized by circumferential growth pattern. The diagnosis of ring melanomas may be delayed because of their initial hidden location and non-specific symptoms. In addition, ring melanomas may be misdiagnosed and treated as refractory glaucoma or retinal detachment because of their atypical presentation. Such tumours are usually large and extensive at the time of diagnosis, thus associated with worse prognosis.

Patient presentation: This case report presents a case of a 70-year-old female presenting with blurring of vision of 1 month duration. Examination revealed a pigmented subconjunctival mass just inferior to the lower limbus that the patient reported to appear 1 year before. Dilated fundus and ultrasonographic examination were suggestive of ciliochoroidal melanoma with associated retinal detachment.

Management and outcome: The patient underwent enucleation, and histopathology confirmed the diagnosis of ciliochoroidal melanoma of mixed cell type.

Conclusion and Contribution: This article aims to report a rare and advanced case of a deadly tumour emphasizing on the importance of routine fundus examination in patients over the age of 40 years.