Choroidal melanoma

Choroidal melanoma is a rare malignant tumor and represents the most frequent primary intraocular tumor, occurring in six cases/million/year. It appears as a pigmented lesion, its color varying from creamy-white to gray-brown. Its clinical presentation, size (small, intermediate, large), and shape (dome or mushroom shaped, flat, multinodular, or small) are important factors to consider for management. Symptoms arise when it affects surrounding visual anatomic structures, such as the retina or optic nerve causing retinal detachment or visual disturbances. Diagnosis is based on clinical fundus examination and ultrasonography. Ancillary tests might be useful in specific cases for differential diagnosis and monitoring progression and response to treatment. Conservative radiation therapy using radioactive plaques or external proton beam radiation is the preferred treatment method, while enucleation is still performed for selected tumors. Prognosis depends on the size and location of the tumor, as well as the risk of liver metastasis, which is enhanced in the presence of tumoral cytogenetic mutations, such as monosomy 3.