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Breve M. A., D’amico G., Caiazzo A., Rossi C., Piedepalumbo M.
Università Federico II di Napoli, Dipartimento assistenziale di oftalmologia, direttore Prof Giovanni Cennamo
The melanocytoma of the head of the optical disc it is always benign as a pigmented congenital tumor that, above all in the past, often came confused with juxtapapillary choroidal melanoma with consequence one damaging enucleations. It often manifests in subjects with abundant cutaneous pigmentation (black, Asian, Mediterranean race), with equal frequency in the two sexes. In the starting phases it could be appeared as hypopigmented since third, quarter decade of life.
The Aim of our study is to illustrate, through the exposure of a clinical case, the clinical and above all echography characteristics of the melanocytoma and to demonstrate the echography that it is decisive for this diagnosis. This tumor appears asymptomatic and is found by ophthalmoscopy routine examinations, although this methodical is not free from diagnostic errors some biomicroscopical characteristics afford in fact already one a first diagnostic suspicion the diagnosis differential with juxtapapillary choroidal melanoma on the single base of the ophthalmoscopy maybe difficult. Both the lesions are pigmented, although the optic disk melanocytoma has much pigments, uniform colors, does not give decrease of the visual and does not increase in the short period. The echography b-scan evidences a solid lesion of the head of the optical disc and an exact topographical localization supplies us. The A-scan echography instead evidences the characteristics of upper-middle reflectivity to irregular and the characteristic absence vascularization of such lesions that are so much different from the characteristic of the choroidal melanoma allowing us to make a correct differential diagnosis