Amelanotic Melanoma

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File number: 133549


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    Appears in
    Miscellaneous
    Condition/keywords
    amelanotic melanoma
    Photographer
    @eyemissu2
    Imaging device
    Fundus camera
    TOPCON TRC-50DX
    Description
    This case highlights an amelanotic melanoma, an atypical presentation of a choroidal melanoma lacking the characteristic pigmentation. These lesions can easily be mistaken for choroidal hemangiomas, metastases, or inflammatory masses. Clinically, the lesion appears as a dome-shaped, yellowish subretinal mass, often associated with subretinal fluid, lipofuscin deposition, or retinal detachment. The absence of pigment can delay diagnosis, making multimodal imaging essential. Diagnostic tools: • B-scan ultrasound: low to medium internal reflectivity • OCT: overlying subretinal fluid and RPE elevation • FAF: orange pigment and RPE disruption • ICG/FA: variable, often hypofluorescent core Important: Prompt referral to ocular oncology is critical for management and prognosis.

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