PURPOSE: The authors present the unique clinical features of cavitary uveal melanoma. DESIGN: Retrospective chart review. PARTICIPANTS: Eight patients with cavitary uveal melanoma. MAIN OUTCOME MEASURES: The clinical, ultrasonographic, and histopathologic features of eight patients with cavitary melanoma of the ciliary body were studied. RESULTS: In all eyes there was a brown ciliary body mass that blocked transmission of light on trans-scleral transillumination. Ocular ultrasonography revealed a large, single hollow cavity (unilocular "pseudocyst") in five cases and multiple hollow cavities (multilocular "pseudocyst") in three cases. The cavity occupied a mean of 55% of the entire mass thickness (range, 31%-79%). In five cases, a basal uveal mass was noted on ultrasonography. Four patients underwent tumor resection; one had enucleation, and three had 125I radioactive plaque treatment. In the five cases confirmed histopathologically, the cavitation was empty, contained erythrocytes, serous fluid, and/or pigment-laden macrophages. In no case was the cavity lined by necrotic tumor, endothelial cells, or epithelial cells. CONCLUSION: Ciliary body melanoma can develop an intralesional cavity resembling an intraocular cyst. The presence of a solid mass at the base and a thick wall surrounding the cavity can assist in the differentiation of cavitary melanoma from benign cyst.
PURPOSE: The authors present the unique clinical features of cavitary uveal melanoma. DESIGN: Retrospective chart review. PARTICIPANTS: Eight patients with cavitary uveal melanoma. MAIN OUTCOME MEASURES: The clinical, ultrasonographic, and histopathologic features of eight patients with cavitary melanoma of the ciliary body were studied. RESULTS: In all eyes there was a brown ciliary body mass that blocked transmission of light on trans-scleral transillumination. Ocular ultrasonography revealed a large, single hollow cavity (unilocular "pseudocyst") in five cases and multiple hollow cavities (multilocular "pseudocyst") in three cases. The cavity occupied a mean of 55% of the entire mass thickness (range, 31%-79%). In five cases, a basal uveal mass was noted on ultrasonography. Four patients underwent tumor resection; one had enucleation, and three had 125I radioactive plaque treatment. In the five cases confirmed histopathologically, the cavitation was empty, contained erythrocytes, serous fluid, and/or pigment-laden macrophages. In no case was the cavity lined by necrotic tumor, endothelial cells, or epithelial cells. CONCLUSION: Ciliary body melanoma can develop an intralesional cavity resembling an intraocular cyst. The presence of a solid mass at the base and a thick wall surrounding the cavity can assist in the differentiation of cavitary melanoma from benign cyst.
Authors: Pietro Valerio Foti; Mario Travali; Renato Farina; Stefano Palmucci; Corrado Spatola; Luigi Raffaele; Vincenzo Salamone; Rosario Caltabiano; Giuseppe Broggi; Lidia Puzzo; Andrea Russo; Michele Reibaldi; Antonio Longo; Paolo Vigneri; Teresio Avitabile; Giovani Carlo Ettorre; Antonio Basile Journal: Insights Imaging Date: 2021-06-03