The persisting pseudomelanoma problem.

We reviewed 6,169 cases in which whole eyes were submitted to the Armed Forces Institute of Pathology (AFIP), Washington, DC, between January 1970 and December 1980. We sought to determine whether there had been any change in the frequency of incorrect diagnoses of malignant melanoma since two previous studies had been conducted at the AFIP. Of 744 eyes with clear media submitted with the clinical diagnosis of malignant melanoma, the rate of incorrect diagnosis was 6.4% (48 of 744 cases). During the 11-year study, the rate of incorrect diagnoses declined from 12.5% to 1.4%. Despite that overall decrease, the locations and frequency of simulating lesions were comparable with those found in the two previous studies. We believe our current findings reflect a significant increase in diagnostic accuracy among clinicians practicing outside of major academic centers.