Purpose: To report a case of choroidal melanoma and circumscribed choroidal hemangioma which developed in the same eye. The choroidal melanoma was treated with plaque radiotherapy but showed rapid recurrence which necessitated enucleation.
Case: A 59-year-old man presented with central scotoma and metamorphopsia in the left eye. The left eye showed brownish choroidal elevation above the optic disc and orange-red flat elevation in the lower temporal area of the macula. These were diagnosed as choroidal melanoma and circumscribed hemangioma. Since the choroidal melanoma was medium-sized with no metastasis, it was treated with plaque radiotherapy. The choroidal melanoma regressed after the treatment, but 18 months later showed rapid recurrence resulting in subsequent serious hemorrhage from the tumor. The patient was blinded by hemorrhagic total retinal detachment and consequently underwent enucleation 20 months after plaque radiotherapy. Histopathological examination revealed extreme dilatation and disruption of large tumor vessels in the choroidal melanoma. The cavernous hemangioma was observed in the other site.
Conclusions: There are no reports of simultaneous choroidal melanoma and circumscribed hemangioma in the same eye. The vascular dilatation within the tumor suggests the influence of irradiation.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 121: 593-600, 2017.