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Diffuse Pigmentary Retinopathy and Preretinal and Perivascular Intraretinal Invasion of Choroidal Malignant Melanoma

Abdhish R. Bhavsar, MD1; Danielle R. Sandler, BA2; Amanda C. Maltry, MD3
[+] Author Affiliations
1Retina Center of Minnesota, Phillips Eye Institute, Minneapolis
2Midwestern University, Glendale, Arizona
3Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis
JAMA Ophthalmol. 2015;133(9):1092-1094. doi:10.1001/jamaophthalmol.2015.1817.
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This case report describes malignant melanoma with perivascular retinal invasion.

Invasion of the retina by malignant choroidal melanoma is relatively common, occurring in 23% to 40% of enucleated eyes.1,2 Limited invasion typically occurs after the tumor penetrates Bruch’s membrane and migrates into overlying retina. Widespread proliferation of melanoma cells within the vitreous and invasion of nonadjacent retina are rare.13 We report a case of malignant melanoma with preretinal membrane proliferation of tumor and perivascular retinal invasion, clinically resembling retinitis pigmentosa.

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Figure 1.
Montage Color Fundus Photograph, Transvitreal Fine-Needle Aspiration Biopsy, and Histopathology

A, Montage color fundus photograph of the right eye showing diffuse pigmentary retinopathy, preretinal and perivascular retinal pigment, and choroidal mass. B, Transvitreal fine-needle aspiration biopsy showing clusters of round tumor cells with prominent nucleoli and fine pigment granules (hematoxylin-eosin, original magnification ×200). C, Histopathology showing lobular tumor eroding through the neurosensory retina (hematoxylin-eosin, original magnification ×10).

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Figure 2.
Histology of the Tumor, Retinal Surface, and Perivascular Retina

A, Histology of the tumor showing spindle B melanoma cells with densely pigmented cytoplasm (hematoxylin-eosin, original magnification ×200). B, Histology of the retinal surface showing epiretinal spherules of tumor cells with discontinuous malignant membrane (hematoxylin-eosin, original magnification ×10). C, Histology of the perivascular retina showing intraretinal invasion of tumor cells distributed in a perivascular pattern (hematoxylin-eosin, original magnification ×50).

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