An older adult patient with metastatic cervical cancer noted painless brown pigmentation of the lips with vision loss. The patient developed rapid-onset cataract with visual acuity of hand motions and no fundus view in both eyes. Ultrasonography demonstrated bilateral, multifocal, choroidal thickening. Patchy pigmentation of the lips, palate, and buccal mucosa was noted. After cataract surgery, fundus evaluation revealed multifocal pigmented choroidal lesions, with shallow subretinal fluid, lipofuscin orange pigment, and giraffe skin–like hyperautofluorescence (Figure). These features suggested bilateral diffuse uveal melanocytic proliferation (BDUMP). Sub-Tenon corticosteroid injection was administered bilaterally.
Sen M, Laiton A, Shields CL. Mucocutaneous Pigmentation in a Patient With Bilateral Diffuse Uveal Melanocytic Proliferation. JAMA Ophthalmol. 2022;140(8):e222510. doi:10.1001/jamaophthalmol.2022.2510
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