Malignant transformation of an optic disk melanocytoma

PURPOSE: To report a case of malignant transformation of an optic disk mela nocytoma with a second melanocytoma in the ciliary body. METHODS: Clinical-data including visual acuity, visual fields, color fundus photographs, fluorescein angiogram, and ultrasonogram and histopathologic studies of this case were reviewed. RESULTS: The right eye of a 65-year-old white woman was diagnosed with mela nocytoma of the optic nerve. Four years later, the turner became significan t-ly larger. The best-corrected visual acuity declined from 20/40 to counti ng fingers and the size of the tumor increased fourfold in 2 years. The rig ht globe was enucleated. Histopathologic studies demonstrated moderately pi gmented spindle-B malignant melanoma cells adjacent to and within a populat ion of large, polyhedral, heavily pigmented melanocytoma cells that extende d to the lamina cribrosa and optic nerve. There was also a deeply pigmented melanocytoma in the ciliary body. CONCLUSION: This is a rare case of malignant melanoma transformed from an o ptic disk melanocytoma. Periodic follow-up of the patient with optic disk m elanocytoma is necessary. (Am J Ophthalmol 1999;127:710-714. (C) 1999 by El sevier Science Inc. All rights reserved.).