Case series

Clinical characteristics of uveal melanoma: a case series from a secondary level hospital

Authors

• • Boris Baković boris3bak@gmail.com Email Boris Baković. (compose email, opens in email app.)
  • Public Health Institution Hospital Zvornik, Republic of Srpska, Bosnia and Herzegovina
• • Sladjana Prodanović
  • Public Health Institution Hospital Zvornik, Republic of Srpska, Bosnia and Herzegovina
• • Ana Dimitrijević
  • University Clinical Center of Serbia, Belgrade, Serbia
• • Aleksandar Risimić
  • University Clinical Center of Serbia, Belgrade, Serbia
• • Nada Avram
  • University of East Sarajevo, Faculty of Medicine Foca, Foča, Republic of Srpska, Bosnia and Herzegovine

Abstract

Introduction. Uveal melanoma is the most common primary malignant intraocular tumor in adults, characterized by a high risk of haematogenous metastasis, particularly to the liver. The clinical presentation varies considerably, from asymptomatic lesions discovered incidentally to severe visual impairment. Early diagnosis and multidisciplinary management are essential to optimize functional and oncological outcomes. This study presents the clinical characteristics and diagnostictherapeutic management of patients with uveal melanoma treated at a secondarycare hospital.
Case series. Three patients with different clinical presentations of uveal melanoma were evaluated. A 53-year-old man presented for routine presbyopic correction without any visual complaints. Fundus examination revealed serous retinal detachment associated with a pigmented choroidal lesion. B-scan ultrasound confirmed an intraocular tumor, and enucleation was performed after multidisciplinary assessment. Histopathology confirmed choroidal melanoma. A 63-year-old woman presented with floaters in the left eye. Ophthalmic examination identified a pigmented superotemporal choroidal lesion; subsequent diagnostic workup confirmed melanoma. She underwent brachytherapy and maintained good visual acuity without metastases during followup. A 58-year-old man with progressive visual decline had been previously treated for chronic uveitis and cataract. Initial B-scan findings were inconclusive; however, intraoperative suspicion of a ciliary body melanoma during cataract surgery prompted ultrasound biomicroscopy, which confirmed the tumor. Iridocyclectomy was subsequently performed, with a postoperative uncorrected visual acuity of 0.6.
Conclusion. Uveal melanoma can present with diverse and subtle clinical manifestations, underscoring the importance of a detailed fundus examination even in asymptomatic patients. Diagnostic challenges are particularly evident in ciliary body melanoma, where standard ultrasonography may be inconclusive.

Keywords: uveal melanoma, choroidal neoplasms, ciliary body, ultrasonography, optical coherence tomography

How to Cite: Baković, B. , Prodanović, S. , Dimitrijević, A. , Risimić, A. & Avram, N. (2026) “Clinical characteristics of uveal melanoma: a case series from a secondary level hospital”, Biomedicinska istraživanja. 17(S1). doi: https://doi.org/10.59137/BII202601638B