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Marsupialized Fungal Mycetoma Masquerading as Conjunctival Melanoma

Sayyad, Fouad E. MD*; Karp, Carol L. MD*; Wong, James R. BS*; Weiss, Matthew J. MD*; Bermudez-Magner, J. Antonio MD, FICO; Dubovy, Sander MD*,†

doi: 10.1097/ICO.0000000000000146
Case Report

Purpose: To report a case of a fungal mass misdiagnosed as a pigmented conjunctival melanoma.

Method: Case report.

Result: A 38-year-old woman was referred for a pigmented conjunctival lesion that was diagnosed as a melanoma. She had a history of a scleral buckle in that eye for retinal detachment 2 years before presentation. Slit-lamp examination revealed a pigmented mass from the 11- to 2-o'clock position. This was noted to be imbricated within the invagination of a conjunctival fold from the previous surgery. The mass was removed, cultured, and confirmed to be a fungal infection from Scytalidium sp.

Conclusions: Scleral buckles can cause folds in the conjunctiva, which can be foci for fungal infection.

Author Information

*Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL; and

Florida Lions Eye Bank, Miami, FL.

Reprints: Carol L. Karp, MD, Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 900 NW 17th Street, Miami, FL 33136 (e-mail:

Supported by NIH Center Core Grant P30EY014801, Research to Prevent Blindness Unrestricted Grant, Department of Defense (DOD-Grant W81XWH-09-1-0675). The Ronald and Alicia Lepke Grant, The Lee and Claire Hager Grant, The Jimmy and Gaye Bryan Grant, and The Richard Azar Family Grant (All institutional grants).

The authors have no conflicts of interest to disclose.

Received September 18, 2013

Accepted April 02, 2014

© 2014 by Lippincott Williams & Wilkins.