UVEAL MELANOMA EXTENSION TO THE OPTIC CHIASM

Abstract

Purpose: 

Case report describing a patient who developed intracranial extension of a uveal melanoma through the optic nerve.

Methods: 

We reviewed the patient's medical history and images. A 41-year-old woman who was blind in one eye had a uveal melanoma that extended through the optic nerve into the optic chiasm and involved the hypophysis. The patient then developed metastasis.

Results: 

The patient developed uveal melanoma extension into the optic chiasm through the optic nerve resulting in a visual field defect in the fellow eye.

Conclusion: 

Uveal melanoma extension through the optic nerve is a devastating complication, which occurs anywhere from 0.6% to 3.7% in patients with uveal melanoma. If enucleation of the affected eye is performed, a representative portion of the optic nerve should be excised to decrease the risk of extension. Patients with phthisical eyes should undergo appropriate imaging techniques to prevent a missed diagnosis of optic nerve involvement.

In Brief

Local extension of uveal melanomas usually involves the orbit and rarely extension through the optic nerve. The authors present a case of a patient who was blind in one eye and developed temporal hemianopia in the fellow eye from involvement of the optic nerve and extension into the chiasm.