The value of medical imaging techniques in the diagnosis of extra-ocular extension of malign melanoma of the choroid: a case report.

The major goal in the evaluation of posterior uveal tumours is to determine whether an intra-ocular malignancy is present and whether intervention is necessary. Small uveal pigmented tumours can safely be managed by observation until growth is documented. However, extensive evaluation for each suspicious lesion is necessary in order not to miss any signs of malignancy. A case is presented of a 41 year old male patient with orbital pain as initial symptom of a choroidal melanoma. Fluorescein-angiography revealed signs of double circulation. Abnormal choroidal vessels inside the tumour showed up clearly on indocyanine-green angiography. By ultrasonography we were able to detect scleral perforation and extra-scleral extension. Computed tomography confirmed the extra-scleral extension. As there were no signs of metastasis, an orbital exenteration with sparing of the eyelids was performed. Histopathology is compared with the results of clinical investigation.