TY - JOUR T1 - Finding malignant change in a necrotic choroidal melanocytoma: a clinical challenge JF - British Journal of Ophthalmology JO - Br J Ophthalmol SP - 921 LP - 922 DO - 10.1136/bjo.2004.060038 VL - 89 IS - 7 AU - M Kurli AU - P T Finger AU - T Manor AU - S A McCormick AU - H E Grossniklaus Y1 - 2005/07/01 UR - http://bjo.bmj.com/content/89/7/921.abstract N2 - Melanocytic intraocular tumours can grow as to exceed their vascular supply, become necrotic, and induce inflammation. They present with atypical signs and become a diagnostic challenge. We present a case of a large melanocytic intraocular tumour that offered an atypical presentation, unexpected cytology, and finally diagnostic histopathology. A 37 year old white woman presented with a painful right eye and vision loss. Exam ination showed no light perception, a relative afferent pupillary defect, a shallow anterior chamber, and an intraocular pressure of 58 mm Hg. Dense vitreous haemorrhage and tumour obscured her fundus. Three dimensional ultrasonography revealed vitreous haemorrhage, a total retinal detachment, and a large choroidal mass (fig 1A, B). Computed tomography and magnetic resonance imaging (MRI) of the orbits showed a 2 cm intraocular mass with a collar-button extension (arrow) consistent with a choroidal melanoma (fig 1C). Figure 1  (A) B-scan ultrasound demonstrated a large intraocular tumour with scleral thickening and retrobulbar oedema. There was almost no intrinsic vascularity noted within the tumour. No … ER -