Long-standing choroidal melanoma with transscleral and intracranial extension. Clinical case

Choroidal melanoma (CM) originates from melanocytes residing in the uveal tract due to their malignant transformation. It affects the choroid and is considered the most frequent primary intraocular cancer in adulthood, comprising 85 % of all eye neoplasms and is associated with high metastatic risk, which makes it one of the most aggressive tumors. Despite earlier successful local treatment of the primary tumor, up to half of all CM patients will eventually develop metastatic disease, particularly to the liver, which makes survival prognosis poor. One of the factors that initiates melanocytic malignant transformation is genetic predisposition. In some cases, CM presents with extrascleral extension forming extrabulbar tumor foci. The literature suggests that extraocular tumor extension has been noted to occur in up to 2–3 % of cases primarily presenting with uveal melanoma and is associated with poor vital prognosis and more aggressive disease course. Herein, we report a case study of long-standing choroidal melanoma that has resulted in significant transscleral tumor growth and its intracranial extension presenting no signs of metastatic disease at the time of presentation to the Burdenko Neurosurgical Center.

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