Case #17: Ultrasound of Intrinsic Vascularity

By Paul T. Finger, MD

History

A 67 year old male was referred to The New York Eye Cancer Center with a 18 x 18 mm base, and 9.3 mm high dome-shaped tumor in his left eye.

A dynamic 10 MHz ultrasound reveals the "twinkling" of blood as it flows within a choroidal melanoma.
A dynamic 10 MHz ultrasound reveals the “twinkling” of blood as it flows within a choroidal melanoma.

Note

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Note the “twinkling” within the tumor.

This is caused by blood circulating within the melanoma. You can use this observation to differentiate between benign and malignant tumors. In general, malignant tumors have an active circulation as compared to “pseudo-melanomas” like a choroidal hemorrhage. The “twinkling” represents intrinsic vascularity or blood flow. Blood flow and vascularity will be found to diminish after radiation therapy.

Impression

Large Choroidal Melanoma

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