Orbital Malignant Melanoma Diagnosed after Evisceration for Neovascular Glaucoma

ABSTRACT

Malignant melanoma is the most common intraocular tumor in adults. Extrascleral extension has been reported to occur in 10% to 28% of patients with choroidal melanoma, and the mortality rate is much higher than that for patients without extrascleral extension. Many ophthalmologist are familiar with the difficulties that may occur in the clinical diagnosis of malignant melanoma. Especially it is very difficult if there are glaucoma, cataract, and retinal detachment. In this situation the evisceration procedure probably did permit the development of an orbital recurrence of malignant melanoma. A 50-year-old woman developed orbital mass 2 month after evisceration at the right eye for neovascular glaucoma and the patient was managed by orbital excenteration and radiotheraphy. If there are glaucoma, cataract, and retinal detachment of unknown causes, the ultrasonography and other radiologic study should be done for unsuspected malignant tumor.