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Jerry A Shields, Carol L Shields; Mushroom shaped choroidal lesions other than melanoma. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4410.
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© ARVO (1962-2015); The Authors (2016-present)
There is a general belief that a mushroom shaped fundus mass is highly suggestive, or even pathognomonic, of a uveal melanoma.
We reviewed the charts of patients referred to an Ocular Oncology Service with lesions that were coded as having a mushroom shape clinically and with ultrasonography, but who proved on further evaluation to have lesions other than uveal melanoma. We also reviewed the literature on other similar cases.
A total of 14 conditions, other than melanoma, that had a mushroom configuration were identified. Those seen personally by the authors included adenocarcinoma of the retinal pigment epithelium, metastatic lung cancer, late recurrence of retinoblastoma, ciliary body leiomyoma and a mycotic abscess. Those shared with us by colleagues and/or cited in the literature included metastatic lung cancer, metastatic thyroid cancer, ciliary body schwannoma, choroidal hemangioma, age related macular degeneration, mycotic fungal abscess, retinal vasoproliferative tumor, solitary fibrous tumor of sclera, and idiopathic fibrovascular proliferation.
There are well-established cases of lesions other than uveal melanoma that can assume a mushroom configuration clinically and with ultrasonography. Clinicians should be aware of the these mushroom shaped pseudomelanomas in order to make an accurate diagnosis and avoid inappropriate management.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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