Melanosis oculi, small choroidal melanoma, and extraocular extension.

In a white patient with melanosis oculi, a small choroidal melanoma in the hyperpigmented eye was observed for 8 years before enucleation. An important factor in the decision to enucleate was echographic evidence of extraocular tumor extension. Histopathologic examination confirmed the presence of a small choroidal melanoma (with an intraocular tumor volume of about 60 mm3), scleral tumor infiltration, and extrascleral tumor extension. Discussion considered the reported association of melanosis oculi with uveal melanoma in white patients, the extremely important role of echography in the management of even small choroidal melanomas, and the significance of extraocular tumor extension.