Ten percent of choroidal malignant melanomas diagnosed microscopically are unsuspected.1 Advanced glaucoma is the reason for enucleation in over 90% of such cases. About 25% of these unsuspected tumors are markedly necrotic; they are often manifested clinically by signs of a severe uveitis, endophthalmitis, or panophthalmitis. Phthisical eyes, blind for years and removed for cosmetic reasons, occasionally contain a malignant melanoma.2 Acute trauma, on the other hand, is an unusual cause for enucleation of an eye that contains a malignant melanoma. The purpose of this report is to record such a case.
Report of a Case
A 53-year-old white woman was examined because of an inflamed right eye. There was extensive chemosis, and conjunctival tissue appeared to have grown over the cornea. The globe was hard, and there was no light perception. Although no wound was apparent, a penetrating injury was thought to have occurred several weeks earlier.
SPAULDING AG, NAUMANN G. Unsuspected Malignant MelanomaEnucleation Following Trauma and Endophthalmitis. Arch Ophthalmol. 1966;76(4):578-579. doi:10.1001/archopht.1966.03850010580017