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Inicio Archivos de la Sociedad Española de Oftalmología (English Edition) Giant optic disk melanocytoma complicated with massive intraocular seeding
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Vol. 86. Issue 5.
Pages 158-161 (May 2011)
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Vol. 86. Issue 5.
Pages 158-161 (May 2011)
Short communication
Giant optic disk melanocytoma complicated with massive intraocular seeding
Melanocitoma gigante de la papila óptica complicado con siembra intraocular masiva
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R.L. Fonta,
Corresponding author
rfont@bcm.tmc.edu

Corresponding author.
, V. Chaqués-Alepuzb
a Cullen Eye Institute, Baylor College of Medicine, Houston, USA
b Hospital Arnau de Vilanova, Valencia, Spain
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Abstract
Case report

A 33-year-old female with a large, unilateral, dark tumor of the optic disk with a presumed diagnosis of melanocytoma. After a follow-up of nineteen years, the tumor produced massive intraocular seeding with cataract, secondary glaucoma (pigmentary, melanocytomalytic, inflammatory and pupillary seclusion glaucoma) and amaurosis. The eye is enucleated and the pathological examination confirmed the diagnosis.

Discussion

Optic disk melanocytoma is a benign stationary tumor. However, sometimes there are complications, including visual loss. Our case confirms that vitreous seeding is due to tumor necrosis with dissemination of tumoral debris and melanin, which are phagocytized by macrophages and produce an inflammatory reaction, trabecular plugging and ocular hypertension.

Keywords:
Magnocellular nevus
Melanocytoma
Optic disk
Pigment dispersion
Glaucoma
Resumen
Caso clínico

Mujer de 33 años con gran tumoración oscura sobre papila óptica unilateral diagnosticada presuntamente como melanocitoma. Tras seguimiento de 19 años, la tumoración produce siembra intraocular masiva con catarata, glaucoma secundario (pigmentario, melanocitomalítico, inflamatorio y seclusión pupilar) y amaurosis. Tras enucleación se confirma anatomopatológicamente el diagnóstico.

Discusión

El melanocitoma de papila óptica es un tumor benigno estacionario, pero raras veces ocasiona complicaciones incluida la pérdida visual. Nuestro caso corrobora que la siembra vítrea está causada por necrosis tumoral con diseminación de detritus tumorales y melanina, que fagocitados por macrófagos, producen reacción inflamatoria, ocupación trabecular e hipertensión ocular.

Palabras clave:
Nevus magnocelular
Melanocitoma
Papila óptica
Dispersión pigmentaria
Glaucoma

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