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2004 Series -  July 20, 2004 Lecture 24 of 50  NEXT»

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A 55-year-old female has noted "flashes" in front of her right eye for three months as well as a "dark spot" in her vision temporally in the right eye.  She has 20/20 vision in each eye unaided and is otherwise healthy.  A large lesion is present below the disc and macula of the right eye.  This lesion is shown on B-scan and an MRI is included. 

1.  The most likely diagnosis in this case is: 
 

a. melanoma
b. Eales disease
c. serous detachment
d.  Coats disease

2.  The patient should be followed with:   
 

a. observation every three months to watch for growth
b. annual chest and abdominal CT
c. liver enzymes for tumor screening
d.  all of the above

3.  The following can be said about this patient:   
 

a. this is likely to be a spindle A or B variety of melanoma with a low potential for metastases
b. plaque therapy with I 125 is not indicated
c. enucleation is not the treatment of choice now
d.  all of the above


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