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Carcinoma Ex Pleomorphic Adenoma A 76-year-old female referred by primary care physician for right eye proptosis. The patient complained of diplopia for the last six months without associated pain or irritation. External exam was significant for proptosis of the right eye and hypoglobus. Visual acu…

Choroidal Metastasis Consistent with Renal Cell Primary A 57-year-old male presented to clinic with a one-week history of red line in his vision OS. The patient was noted to have a history of left nephrectomy for renal cell carcinoma that was diagnosed after a metastatic lesion was detected in the …

Chroroidal Osteoma is a rare benign tumor characterized by the presence of cancellous bone within the peripapillary choroid

Slit lamp photo with white tumor growing into the sulcus inferior temporally. The Ultrasound Biomicroscopy shows a medium density mass in the ciliary body. The patient had known stage 4 lung cancer.

A large pigmented nasal growth with vascularization. This case was treated with surgery using a 'no touch technique' excisional biopsy with 4 mm margins and amniotic membrane tissue placement.

Conjunctival Melanoma A 38-year-old healthy man presents with a pigmented lesion two years after onset and undergoes excisional biopsy which confirms conjunctival melanoma. Systemic work-up reveals metastasis, and the patient undergoes multiple cycles of radiation and chemotherapy. He later died of…

Extranodal Marginal Zone Lymphoma 52-year-old male with Stage IV extranodal MALT lymphoma who initially presented with paranasal and perioribtal disease. He failed treatment with multiple chemotherapeutic agents and represented with decreased VA 20/40 and 20/80 thought to be due to diffuse choroida…

Exudative Retinal Detachment Following Treatment of Posterior Uveal Melanoma A 55-year-old male presented to Bascom Palmer with complaints of flashing lights in his right eye and found to have a large choroidal mass. Work-up revealed a likely choroidal melanoma with an associated small inferior exu…

Granular Cell Tumor The patient presented to BPEI for evaluation of a two-week history of worsening diplopia. Examination revealed left unilateral proptosis. MRI orbit imaging revealed an intraorbital well-defined, well-circumscribed lesion arising at the level of the medial rectus. The patient und…

The patient presented with an enlarging lower eyelid lesion for 2 months. There was irregular pigmentation without ulceration or madarosis. Biopsy confirmed an intradermal nevus.

Metastatic Cutaneous Melanoma to Choroid An elderly patient presented with vision loss in the right eye and self-referred to BPEI for a second opinion. A pigmented, elevated choroidal lesion concerning for malignancy was noted in the right eye with sub retinal fluid extending into the macula. The p…

In this module, we will look at:




Orbital Oncology


Conjunctival Oncology


Retinal Oncology


Uveal Oncology

Orbital Venous Lymphatic Malformation A patient presented to the ER complaining of 2 days of increasing pain and swelling behind the left eye. Of note the patient reported that as a teenager he was previously treated for an orbital tumor. On exam he was found to have massive proptosis, hyperglobus …

A patient with orbital venous lymphatic malformation causing massive proptosis. MRI demonstrates an enhancing, T1 hypointense, T2 hyperintense, lobulated mass with small blood-fluid levels in the left medial orbit compressing the globe and causing bony deformation of the bony orbit. Surgical specim…

Primary Uveal Melanoma, Left Eye A 30-year-old Hispanic female with a history of thyroid disease presented to the Bascom Palmer ER with complaints of blurry vision and eye strain in the left eye while reading for a 1-month duration. Her last eye exam was a decade ago and was normal. She was diagnos…

Pseudoangiomatous Retinal Gliosis A 54-year-old Hispanic male presented with decreased vision in the right eye over 3 months. Dilated fundus exam of the right eye showed a geographic area of chorioretinal alteration in the far temporal periphery at 9 o’clock, a gliovascular retinal mass superiorl…

Retinoblastoma A 2-year-old female with an unremarkable past medical history presented with pain and swelling of the left eye. One examination she was able to fix and follow with both eyes but had a dull red reflex of the left eye as well as a retinal mass. An exam under anesthesia was performed wh…

Squamous Cell Carcinoma, Metastatic Prostatic Adenocarcinoma A 77-year-old Caucasian male with a history of locally advanced prostate cancer on androgen deprivation therapy presented to BPEI for evaluation of a right lower lid lesion present for six weeks that did not improve with conservative trea…

Large sub-ILM hemorrhage leading to sub-retinal exudative changes in a patient with leukemia.

Uveal Effusion Syndrome A patient was referred to the ocular oncology service for evaluation of a suspicious choroidal mass and serous retinal detachment in the right eye. The Snellen visual acuity was 20/80 and intraocular pressures were normal in both eyes. Examination and imaging of the right ey…