Abstract：
OBJECTIVE: To report a case of atypical nodular posterior scleritis mimicking as a melanotic choroidal melanoma.
METHODS: Descriptive case report.
RESULTS: A 38-year-old female presented with sudden onset diminution of vision, severe pain and redness in her right eye. She was diagnosed to have choroidal melanoma in her left eye one year ago and underwent enucleation. On examination, conjunctiva was injected in right eye with cells in anterior vitreous face (AVF). Fundus examination revealed a large pigmented choroidal mass temporal to macula with exudative retinal detachment. Systemic evaluation and multimodal imaging ruled out the possibility of a choroidal melanoma or metastasis, with a presumptive diagnosis of nodular posterior scleritis. Three cycles of intravenous methyl prednisolone (IVMP) with a tapering dose of oral corticosteroids showed drastic improvement in symptoms with resolution of choroidal mass - further confirming the diagnosis.
CONCLUSIONS: In cases of choroidal mass with an inflammatory component, a trial of steroids is worthwhile to prevent clinical misjudgement and devastating treatment outcomes including enucleation.
METHODS: Descriptive case report.
RESULTS: A 38-year-old female presented with sudden onset diminution of vision, severe pain and redness in her right eye. She was diagnosed to have choroidal melanoma in her left eye one year ago and underwent enucleation. On examination, conjunctiva was injected in right eye with cells in anterior vitreous face (AVF). Fundus examination revealed a large pigmented choroidal mass temporal to macula with exudative retinal detachment. Systemic evaluation and multimodal imaging ruled out the possibility of a choroidal melanoma or metastasis, with a presumptive diagnosis of nodular posterior scleritis. Three cycles of intravenous methyl prednisolone (IVMP) with a tapering dose of oral corticosteroids showed drastic improvement in symptoms with resolution of choroidal mass - further confirming the diagnosis.
CONCLUSIONS: In cases of choroidal mass with an inflammatory component, a trial of steroids is worthwhile to prevent clinical misjudgement and devastating treatment outcomes including enucleation.
摘要：
目的：报告1例模仿黑色素脉络膜黑色素瘤的非典型结节性后巩膜炎。
方法：描述性病例报告。
结果：一名38岁女性出现突然发作的视力减退，她的右眼剧烈疼痛和红肿。一年前，她被诊断出左眼患有脉络膜黑色素瘤，并接受了摘除手术。在检查中，右眼用玻璃前表面（AVF）细胞注射结膜。眼底检查发现黄斑颞部有大量色素沉着的脉络膜肿块，并伴有渗出性视网膜脱离。系统评估和多模态成像排除了脉络膜黑色素瘤或转移的可能性，疑似诊断为结节性后巩膜炎。三个周期的静脉注射甲基强的松龙（IVMP）与逐渐减少剂量的口服皮质类固醇显示症状的显着改善和脉络膜肿块的消退-进一步证实了诊断。
结论：在具有炎症成分的脉络膜肿块的情况下，类固醇的试验对于防止临床误判和包括摘除在内的破坏性治疗结果是值得的.
方法：描述性病例报告。
结果：一名38岁女性出现突然发作的视力减退，她的右眼剧烈疼痛和红肿。一年前，她被诊断出左眼患有脉络膜黑色素瘤，并接受了摘除手术。在检查中，右眼用玻璃前表面（AVF）细胞注射结膜。眼底检查发现黄斑颞部有大量色素沉着的脉络膜肿块，并伴有渗出性视网膜脱离。系统评估和多模态成像排除了脉络膜黑色素瘤或转移的可能性，疑似诊断为结节性后巩膜炎。三个周期的静脉注射甲基强的松龙（IVMP）与逐渐减少剂量的口服皮质类固醇显示症状的显着改善和脉络膜肿块的消退-进一步证实了诊断。
结论：在具有炎症成分的脉络膜肿块的情况下，类固醇的试验对于防止临床误判和包括摘除在内的破坏性治疗结果是值得的.
