Masquerade Scleritis
- 1 January 2005
- journal article
- case report
- Published by Taylor & Francis Ltd in Ocular Immunology and Inflammation
- Vol. 13 (6), 479-482
- https://doi.org/10.1080/09273940591004133
Abstract
To report two cases in which malignancy masqueraded as scleritis, delaying the diagnosis.Two patients initially diagnosed and treated for unilateral scleritis were referred for management of persistent inflammation. Additional evaluation uncovered underlying malignant processes.The first patient presented with scleritis initially responsive to systemic corticosteroids, with relapse one month later. Upon referral, peripheral fundus examination revealed elevated lesions. Additional studies confirmed the diagnosis of choroidal melanoma. The patient was treated with proton-beam irradiation. The second patient developed necrotizing scleritis unresponsive to systemic steroids, methotrexate, and cyclophosphamide. A scleral biopsy disclosed an undifferentiated high-grade carcinoma, likely metastatic. Exenteration was performed.Scleritis can present a diagnostic challenge. It is often the sole initial manifestation of an occult systemic problem. Treatment-resistant scleritis should raise the suspicion of an infectious or malignant masquerade.Keywords
This publication has 10 references indexed in Scilit:
- Nondiagnosed uveal melanomas,Ophthalmology, 2004
- Evaluation of patients with scleritis for systemic diseaseOphthalmology, 2004
- Proton radiation therapy for medium and large choroidal melanoma: preservation of the eye and its functionalityInternational Journal of Radiation Oncology*Biology*Physics, 2001
- Choroidal melanoma: A review of the experience of the Sydney Eye Hospital Professorial Unit 1979–1995Australian and New Zealand Journal of Ophthalmology, 1997
- Analysis of the incidence of intraocular metastasis.British Journal of Ophthalmology, 1993
- Scleritis as an Initial Manifestation of Choroidal Malignant MelanomaOphthalmology, 1992
- Metastatic Carcinoma Masquerading as ScleritisOphthalmology, 1983
- Ocular Inflammation and Hemorrhage as Initial Manifestations of Uveal Malignant MelanomaAmerican Journal of Ophthalmology, 1979
- Carcinoma Metastatic to the Eye and OrbitAmerican Journal of Ophthalmology, 1975
- Carcinoma Metastatic to the Eye and OrbitAmerican Journal of Ophthalmology, 1974