Metastatic cutaneous melanoma to the vitreous cavity masquerading as intermediate uveitis.

PURPOSE: To report a patient with metastatic cutaneous melanoma (MCM) presenting as intermediate uveitis.

METHODS

We examined a 49-year-old man with malignant cutaneous melanoma and central nervous system (CNS) metastasis who was initially treated for bilateral intermediate uveitis. Biomicroscopic examination disclosed a normal anterior segment and vitreous organization with red blood cells (RBC) and some non-pigmented cells in both eyes. Funduscopy disclosed a retinal metastasis in the right eye, but vitreous organization precluded visualization of the retina in the left eye.

RESULTS

The first diagnostic vitrectomy was negative for malignant cells in the left eye. However, progressive worsening of the condition persuaded us to repeat vitrectomy in the left eye and to do it in the right eye too. Vitreous samples were positive for malignant melanoma cells in both eyes.

CONCLUSIONS

Metastatic cutaneous melanoma to the vitreous cavity is exceedingly rare and may masquerade as intermediate uveitis. It should be considered in the differential diagnosis of unusual uveitis and masquerade syndromes.