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A 55-year-old female has noted “flashes” in front of her right eye for three months as well as a “dark spot” in her vision temporally in the right eye. She has 20/20 vision in each eye unaided and is otherwise healthy. A large lesion is present below the disc and macula of the right eye. This lesion is shown on B-scan and an MRI is included.

3 comments

  1. I consider that melanoma is near optic nerve and the chance of dissemination is very high to nervous system. Please explain why enucleation is not a good idea?

  2. Metastasis is through blood stream mostly .
    Secondly the tumour may begnin and you lost the eye as the definit diagnosis is only can be proved by histopathology

  3. Agree with Shaheed. Unlike tumors like retinoblastoma, melanomas do not generally metastasize by direct spread or invasion, they tend to spread via the blood or lymphatic system. This is why the recommendations for monitoring the lungs and liver.

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