More than Meets the Eye: Metastatic Uveal Melanoma

Excerpt

A 61-year-old man with subacute, abdominal distension presented to the Emergency Department. He also had progressive left eye pain and vision loss for 3 years. Physical examination revealed hepatomegaly and a left afferent pupillary defect. Left intraocular pressure was elevated at 34 mmHg. Ultrasound demonstrated a large mass filling 80 % of the left globe with low-internal reflectivity consistent with uveal melanoma. The left eye had florid iris neovascularization (arrow, Fig. 1) resulting from tumor secretion of vascular endothelial growth factor and prominent sentinel vessels (dotted arrow, Fig. 2) nourishing a tumor infiltrating the uvea (solid arrow, Fig. 2). Most of these findings could be appreciated with penlight examination. Abdominal computed tomography revealed hepatomegaly with hepatic masses, biopsy of which revealed metastatic melanoma.

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