Occult Foreign Body Simulating a Uveal Melanoma with Extrascleral Extension

A 78-year-old woman with complaints of discomfort in the left eye was referred to us for a pigmented and gradually-enlarging tumorous mass on the left sclera. The patient denied ocular trauma. Pigmentation on the iris also was found close to the scleral lesion. The lesion was initially suspected to be a uveal melanoma with extraocular extension. A computed tomographic scan showed a high density mass intraocularly. Second, the lesion was thought to be an intraocular metallic foreign body with uveal prolapse. The lesion was removed surgically and histopathologic examination revealed it to be an iron splinter in the left episclera. We believe that an occult foreign body should be considered in the differential diagnosis of uveal melanoma. Many melanoma-simulating lesions have been reported (1-9). Among them are ones in which a foreign body produces a mass that resembles a malignant melanoma of the uvea with or without extrascleral extension (2,4,7,9). We recently treated an elderly patient who had an episcleral foreign body that simulated a uveal melanoma with extrascleral extension.