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December 1964

Hematoma Beneath the Retinal Pigment EpitheliumReport of a Case Mistaken Clinically for a Malignant Melanoma of the Choroid

Author Affiliations

Washington, DC
United States Air Force Fellow in Ophthalmic Pathology, Armed Forces Institute of Pathology (Major Tredici); Special Fellow in Ophthalmic Pathology, National Institute of Neurological Diseases and Blindness, United States Public Health Service, at the Armed Forces Institute of Pathology (Dr. Fenton).; From the Registry of Ophthalmic Pathology, Armed Forces Institute of Pathology.

Arch Ophthalmol. 1964;72(6):796-799. doi:10.1001/archopht.1964.00970020798010

In its early stages a hematoma beneath the retinal pigment epithelium is said to simulate a malignant melanoma of the choroid more closely than any other lesion.1-3 These hematomas are characterized clinically by the sudden onset of visual loss associated with a dark, rounded thickening at the posterior pole. The hemorrhagic nature of the lesion usually becomes evident within ten days to two weeks after onset, as it begins to clear, or as hemorrhage appears at its edges.

This report concerns a case in which a dark, elevated tumor appeared several weeks after the discovery of a hemorrhagic lesion in the macular area. The rapid appearance of this dark mass, which increased in size and became elevated, led to a clinical diagnosis of malignant melanoma of the choroid, and the eye was enucleated.

Report of Case 

Clinical History.  —An 84-year-old white woman noted the sudden onset of blurred vision

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