Report on a 73-year-old man with a proptosis of the left eye. Standardized A- and B-scan sonography revealed a large orbital tumor with low reflectivity and regular internal structure. Furthermore, a small choroidal melanoma with a typical excavation at its base was detected by echography. It could be demonstrated by reduction of the sound energy that the sclera adjacent to this tumor was intact, suggesting a melanoma migration along small scleral vessel-channels into the orbit. All these findings were proved by histology. The echographical criteria of choroidal melanomas without and with scleral infiltration will be presented and their reliability will be discussed.
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Rochels et al. (2010) studied this question.