|A 75-year-old male presented
with a painful, red left eye. Visual acuity was perception of light, the
anterior chamber was flat and the intraocular pressure was 40 mmHg. He
had a mature cataract and an ultrasound was performed.
The eye was enucleated and the relevant histology is reported below.
“The principal microscopic abnormality
is the presence of a choroidal melanoma situated posteriorly and temporally
within the globe measuring a maximum of 11mm in diameter by 6mm in thickness.
The tumour has breached Bruch’s membrane at its periphery. The tumour is
comprised principally of epitheliod melanocytes. There is no evidence of
scleral or vortex vein invasion in the sections examined.”
1. Name 4 features of the ultrasound which suggest malignant melanoma (4 marks)2. Name the 2 most important poor prognostic features mentioned in the pathology
report. (2 marks) 3. What other cell types may be found in choroidal melanomas? (2 marks) 4. Name 4 investigations you would order in this patient (4 marks)