- Presumed solitary circumscribed retinal astrocytic proliferation (PSCRAP) is a recently described retinal tumour that is a distinct entity from other white lesions of the retina such as astrocytic hamartoma and acquired astrocytoma.1 The exact origin of these lesions is of some debate within the literature as no histological diagnosis exists to date.2,3 These lesions are not associated with tuberous sclerosis complex or related syndromes and can be distinguished from astrocytic hamartomas with imaging.
- A 59-year-old female presented with right eye choroidal melanoma of 9×7 mm basal dimensions and 3.1-mm thickness (Fig. 1A). A complete work-up detected no evidence of systemic metastases. Her melanoma was classified as T1 N0 M0 tumour, categorized as stage I, based on the 7th edition of TNM cancer staging manual of the American Joint Committee on Cancer. The choroidal melanoma was treated with iodine 125 plaque brachytherapy that ultimately controlled the tumour locally. Two years after brachytherapy, a mild elevation of her liver transaminases was noticed.
- A 6-year-old male presented with a large, fleshy mass protruding from the left eye that has been rapidly enlarging for 4 weeks before presentation (Fig. 1A). Since infancy, he manifested with mental retardation, right hemiparesis, motor seizures, and he underwent surgical correction of an undescended testicle. His photograph at the age of 10 months revealed left eye esotropia, hazy cornea, and a flat red lesion on the temporal conjunctiva (Fig. 1B). On examination, the patient exhibited frontoparietal alopecia, faint scalp nevus, multiple eyelid and periocular skin tags, and dental anomalies.
- A 56-year-old white male patient was referred for management of a choroidal mass in his left eye. A cutaneous nevus flammeus involving the right side of his face extending to the right side of his neck and upper chest was noticed (Fig. 1A). On questioning, he mentioned that this nevus flammeus was previously treated with several sessions of dye laser. In addition, the eyelid skin showed a blue-grey hue that involved the upper and lower eyelids bilaterally (Fig. 1B, C). Slit-lamp examination revealed bilateral multiple flat, purple-coloured episcleral patches.
- A 54-year-old female was referred to evaluate a peripheral melanotic fundus lesion in the left eye. A month prior, she noticed a temporal field defect in the same eye. Three months before the ocular symptoms, she underwent bowel resection for small intestinal obstruction caused by multiple tumours in the intestinal wall and regional lymph nodes, which are suggestive of hematogenous metastatic disease. Excised masses were pathologically proved to be metastatic melanoma. The patient provided no definite history of a previous primary melanoma; however, she had a curious account of a pigmented lesion appearing in her forearm skin during pregnancy 20 years earlier, for which a biopsy was not performed and that had spontaneously disappeared postpartum.
- A 37-year-old white male was evaluated for a melanotic fundus lesion with vitreous floaters diagnosed a month prior. Visual acuity was 20/25 in both eyes, with bilateral normal intraocular pressure and anterior segment examination. Funduscopy of the left eye revealed a preretinal spherical dark brown tumour with a smooth surface with minimal subretinal base visible at its superior border (Fig. 1A). Despite its dark colour, prominent vessels could be detected clinically beneath the tumour surface.