Choroidal malignant melanoma with liver metastasis before enucleation.

A case of a relatively small ocular malignant choroidal spindle B-type melanoma showed evidence of metastasis at the time of diagnosis of the initial primary tumor. We believe that, for two reasons, the true incidence of metastatic disease at the time of initial diagnosis of choroidal malignant melanoma is not known incomplete workup at the time of diagnosis, and the high percentage of false-negative results of common tests for detecting metastasis. We believe that all patients with the diagnosis of malignant melanoma should have at least a complete physical examination, liver function tests, liver--spleen scan, bone scan, and chest roentgenogram. If enucleation is performed, it should be done as atraumatically as possible. Some aspects of treatment are controversial. Unfortunately, not enough data regarding malignant melanoma or its metastasis are known to recommended with confidence the best method for treating either condition.