Young patient with choroidal melanoma
a clinical case report
DOI:
https://doi.org/10.70313/2718.7446.v17.n02.329Keywords:
choroidal melanoma, fundus, acute glaucoma, enucleationAbstract
We describe the clinical case of a 34-year-old male patient who consulted the Ophthalmology Emergency Room of the HIGA Rodolfo Rossi, due to pain and right red eye of 48 hours of evolution, diagnosed in another center with acute glaucoma. A complete ophthalmologic examination showed a severe decrease in visual acuity of the right eye associated with moderate ciliary injection, epithelial corneal edema, narrow anterior chamber, arreactive pupil, Tyndall + and increased intraocular pressure, without involvement of the other eye. The right fundus was not visible due to media opacity and no dilation. Ultrasound of the right eye showed a lobulated image in the posterior pole with optic nerve involvement, of medium reflectivity, 14.5 mm high and 10.5 mm wide, with choroidal excavation, compatible with choroidal melanoma. The left eye had no alterations. The Oncology Department was consulted to rule out metastasis and it was decided to perform right eye enucleation with prosthesis placement. The anatomopathologic result reported atypical neoplastic proliferation of pigmented spindle cells, compatible with choroidal melanoma. The importance of the case, beyond the particular youth of the patient with ocular tumor, lies in highlighting the multiple forms of clinical presentation of choroidal melanoma, as well as the fact that it is essential to check the eye fundus in all patients. This will allow early detection of cases that may be initially asymptomatic, in order to perform a prompt treatment to improve the patient’s life expectancy.
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