First Author: P.Coelho PORTUGAL
Co Author(s): R. Carvalho J. Serino B. Vieira C. Menezes J. Lemos R. Gonçalves 0 0 0 0 0 0 0 0 0
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To report three melanocytoma clinical cases with a review about the morphologic characteristics of melanocytoma of the optic disc, their main differential diagnosis, diagnostic approach and management.
Department of Ophthalmology of Hospital Pedro Hispano, Matosinhos, Portugal
Report of three clinical cases
Optic disc melanocytoma, a deeply pigmented variant of the melanocytic nevus, is a benign stationary tumor. Before its diagnose is made, juxtapapilar choroidal melanoma must be ruled out based on imaging findings. The vast majority of melanocytomas exhibit little size variation through the time and do not cause important visual impairment, although small deficits may arise from local complications. Usually the risk of progression to malignant melanoma is extremely low, so a watchful approach by retinography is currently accepted as follow-up procedure. All three cases occurred in female patients with age diagnosis over 50 years old and were incidental findings during routine examinations. The first two cases had previous history of breast cancer. All three fundus examination demonstrated identical unilateral dark-brown masses, partially covering the optic disc with extension to the peripapilar retina. Retinography and fluorescein angiography were performed in order to exclude other pigmented tumors and to document the lesion size. The minimum follow-up time is 8 months and the maximum is 10 years.
Annual dilated fundus examination and retinography revealed no differences in color and size of the lesions, findings that support the initial diagnosis of melanocytoma. However do to rare cases of malignant transformation, even decades after the diagnosis, annual follow-up cannot be interruped.