Choroidal melanoma usually presents as a monocular, monofocal tumor that is dome shaped or mushroom shaped. Occasionally, choroidal melanoma is bilobal and rarely, it is multilobular.1 The present case is a unique multilobulated choroidal melanoma.
An 82-year-old woman sought care at our clinic because of a suspicious macular lesion in her right eye that caused deterioration of the visual acuity to light perception. The visual acuity in the left eye was 0.4 (6/15). An elevated mass, melanotic in its base and amelanotic in its apex, was seen in the macula of the right eye, with some retinal detachment surrounding it. The fundus of the left eye was normal. Ultrasound examination showed a dome-shaped solid mass in the temporal side of the macula, measuring 10.3 mm × 10.4 mm in diameter and 6.1 mm in maximal height, with low internal reflectivity, rimmed by detached retina. The tumor was treated by ruthenium 106 brachytherapy, irradiating 10 200 cGy to the apex and 70 000 cGy to the base of the tumor.
Pe'er J, Barzel I. Multilobular Choroidal Melanoma Following Ruthenium 106 Brachytherapy. Arch Ophthalmol. 2005;123(6):868-869. doi:10.1001/archopht.123.6.868