Not every pigmented tumour is melanoma: Adenoma of the ciliary body pigment epithelium

Abstract

Differential diagnosis between a melanoma and a pseudomelanoma requires many years of experience and ocular studies, and requires paying attention to the smallest details. The case is presented of a 57 year-old male with an adenoma of the ciliary body pigment epithelium that was treated with an enucleation of the eye due to a suspicion of a choroidal melanoma.

Resumen

El diagnóstico diferencial entre melanoma y pseudomelanoma requiere de múltiples estudios clínicos y experiencia en los pequeños detalles. Presentamos el caso de un varón de 57 años con un adenoma del epitelio pigmentario del cuerpo ciliar, al cual se le realizó una enucleación por la sospecha diagnóstica de melanoma coroideo.

Introduction

Choroidal tumors are a frequent cause of visits to the ophthalmologist. Choroidal melanoma is the most frequent primary intraocular malign tumor in the adult population¹. It is estimated that 7095 cases occur annually, mainly in non-Hispanic Caucasians, with incidence increasing together with patient age¹. The main differential diagnostics include choroidal nevus (49%), peripheral exudative hemorrhagic chorioretinopathy (8%) and congenital RPE hypertrophy (6%), among others². The term “pseudo-melanoma” has been applied to conditions that clinically simulate melanoma, leading to diagnostic ambiguity that accounts for up to 14.49% of patients referred due to suspected melanoma². Ciliary body pigment epithelium adenoma is a tumor with benign histological characteristics that does not occur frequently and falls within the category of a pseudo-melanoma. The present case is a male treated with suspected ciliary body melanoma diagnostic.