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Mucocutaneous Pigmentation in a Patient With Bilateral Diffuse Uveal Melanocytic Proliferation

To identify the key insights or developments described in this article
1 Credit CME

An older adult patient with metastatic cervical cancer noted painless brown pigmentation of the lips with vision loss. The patient developed rapid-onset cataract with visual acuity of hand motions and no fundus view in both eyes. Ultrasonography demonstrated bilateral, multifocal, choroidal thickening. Patchy pigmentation of the lips, palate, and buccal mucosa was noted. After cataract surgery, fundus evaluation revealed multifocal pigmented choroidal lesions, with shallow subretinal fluid, lipofuscin orange pigment, and giraffe skin–like hyperautofluorescence (Figure). These features suggested bilateral diffuse uveal melanocytic proliferation (BDUMP). Sub-Tenon corticosteroid injection was administered bilaterally.

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Corresponding Author: Carol L. Shields, MD, Ocular Oncology Service, 840 Walnut St, Ste 1440, Philadelphia, PA 19107 (carolshields@gmail.com).

Conflict of Interest Disclosures: None reported.

Funding/Support: Support provided in part by the Eye Tumor Research Foundation, Philadelphia, Pennsylvania (Dr Shields).

Role of the Funder/Sponsor: The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

References
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Gass  JD , Gieser  RG , Wilkinson  CP , Beahm  DE , Pautler  SE .  Bilateral diffuse uveal melanocytic proliferation in patients with occult carcinoma.   Arch Ophthalmol. 1990;108(4):527-533. doi:10.1001/archopht.1990.01070060075053PubMedGoogle ScholarCrossref
2.
Pulido  JS , Flotte  TJ , Raja  H ,  et al.  Dermal and conjunctival melanocytic proliferations in diffuse uveal melanocytic proliferation.   Eye (Lond). 2013;27(9):1058-1062. doi:10.1038/eye.2013.131PubMedGoogle ScholarCrossref
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Rahimy  E , Sarraf  D .  Paraneoplastic and nonparaneoplastic retinopathy and optic neuropathy: evaluation and management.   Surv Ophthalmol. 2013;58(5):430-458. doi:10.1016/j.survophthal.2012.09.001PubMedGoogle ScholarCrossref
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