Diffuse Choroidal Melanoma

TY is a 25-year-old man who was noted on routine examination to have a dark choroidal lesion with poorly defined margins. Echography revealed low reflective choroidal thickening in the area of the lesion on A-scan and an irregular surface on B-scan (Fig. 280). The differential diagnosis included an infiltrative process either by inflammatory or neoplastic cells. A systemic workup for malignancy was negative. He returned for follow-up in 3 months and the lesion had increased in size. Because of the high probability of diffuse melanoma, the eye was enucleated and pathology confirmed the diagnosis of epitheloid melanoma.