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Imaging of Choroidal Hemangioma and Melanoma
1. HEAD AND NECK IMAGING
EHAB ABOU ELFOTOUH. MD.
ORBITAL IMAGING IV
2. CHOROIDAL HEMANGIOMA:
congenital vascular
hamartomas.
Manifested in middle-
aged or elderly people.
Equal distribution in
both sexes.
3. CHOROIDAL HEMANGIOMA:
solitary choroidal
hemangioma as abenign
vascular neoplasm that
is confined to the
choroid.
Has ill defined margins.
Posterior chamber of the
globe.
Diffuse hemangiomas
occur in Sturge-Weber
syndrome.
4. CHOROIDAL HEMANGIOMA:
CT imaging:
Solitary ill-defined
mass.
Posterior chamber of
the globe.
High CT attenuation.
Intense enhancement.
With or without retinal
detachement.
5. CHOROIDAL HEMANGIOMA:
At MR imaging:
A lenticular shape
mass.
Ill defined margins.
Posterior chamber.
Hyperintense to
vitreous on T1-
weighted images.
6. CHOROIDAL HEMANGIOMA:
On T2WIs, signals
typically hyperintense.
Usually isointense to
vitreous.
enhanced intensely
after the administration
of contrast material.
7.
8.
9.
10. CHOROIDAL MELANOMA:
most common primary
intraocular tumors in
adults.
Melanomas occur in
any of three
subdivisions of uveaL
tract.
From preexisting
melanocytic nevi.
56%of melanomas
occur in those older
than 50 years.
11. CHOROIDAL MELANOMA:
Tumors initially have a
flat growth profile.
later become elevated.
Erupting through the
Bruch membrane with
characteristic
mushroom shape.
12. CHOROIDAL MELANOMA:
Primarily metastasize
to the liver.
Some metastases
manifest before
primary tumor
detection.
In order of decreasing
frequency of distal
metastasis are lung,
bone, kidney, and
brain
13. CHOROIDAL MELANOMA:
Large melanomas (10
mm thick) managed with
enucleation.
medium-
sized lesions (3–10 mm
thick) external-beam
radiationtherapy.
Small tumors (3 mm
thick) follow up 3–6
months with US or
transpupillary
thermotherapy.
25. UVEAL METASTASES:
Through posterior
ciliary arteries.
Commonly involve the
posterior half of the
globe.
primary lesions
common sources of
uveal metastases are
breast and lung
carcinoma.
26. UVEAL METASTASES:
Both eyes are affected
in about one-third of
cases.
Also may involve
extraocular muscles.
MR imaging is superior
to CT.
Signals similar to
Amelanotic
melanomas.