Introduction
Commonly misdiagnosed as choroidal or uveal melanomas, yet the underlying progression is very different.
- Uveal melanomas rarely undergo reactive proliferation
- RPE melanomas typically do undergo reactive proliferation
- RPE adenoma have defining features for distinguishment.
- ~45% of lesions are light mixed, but most are darkly pigmented.
Dead Giveaways
Distinguish from choroidal melanoma:
Typically presents with abrupt elevation, prominent feeder vessels and related exudation
RPE tumours typically invade the vitreous and choroid, but unlike choroidal melanoma, has very low chance of metastasis.
Unlike the spindle epitheloid histology of choroidal melanomas, the RPE lesion shows low cuboidal or columnar cells
diagnostic features
Additional Features:
Typically unilateral
Vision is usually dimmed
Should be suspected if pigmented tumour with lipid exudation, vitreous seeding or vitreous haemorrhages
B-scan ultrasounds reveal a dome or derby hat lesion. It is acoustically solid, without extraocular extension or choroidal excavation
Shows the dome lesion