Aggressive amelanotic choroidal melanoma with extrascleral extension after brachytherapy

Purpose: The purpose of this study was to report a case of amelanotic choroidal melanoma, previously treated with brachytherapy, subsequently exhibiting local extension through pars plana vitrectomy sites. Method: The authors present a retrospective interventional case report from a clinical practice. Results: An amelanotic choroidal melanoma, previously responsive to brachytherapy, underwent two pars plana vitrectomies for nonclearing vitreous hemorrhage with doublefreeze cryotherapy to sclerotomy sites. Recurrent melanoma extended through the sclerotomies presenting as subconjunctival nodules requiring exenteration. Conclusion: Vitrectomy sclerotomy sites may serve as a route of extrascleral extension in previous brachytherapy treatment-responsive choroidal melanomas. Caution should be exercised in performing vitrectomy for choroidal melanomas with subsequent vitreous hemorrhage. copyright