Presenter: Carsten Faber, Denmark
a 25-year-old female, who presented with a large, pale tumor of her ciliary body that extended to more than 180 degrees of the anterior chamber angle
Case Summary:
The patient is a 25-year-old female, who presented with a large, pale tumor of her ciliary body that extended to more than 180 degrees of the anterior chamber angle. All preoperative examinations including ultrasound biomicroscopy, scleral transillumination and MRI indicated melanoma. A thorough systemic work-up was negative. A diagnosis of ring melanoma was suspected, and the patient was scheduled for enucleation. However, perioperative frozen section indicated granulomatous inflammation. The enucleation was cancelled and a subtenon injection of triamcinolone was administered, which resulted in disappearance of the tumor within two months. Together the findings meet the criteria for a diagnosis of isolated ocular sarcoidosis. This case demonstrates that a sarcoid granuloma can mimic all clinical features of a ring melanoma. Therefore, a biopsy should be done before destructive surgery is carried out.