Uveal melanoma physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Fahimeh Shojaei, M.D.

Overview

Patients with uveal melanoma usually appear normal. Physical examination of patients with uveal melanoma is usually remarkable for ophthalmologic findings of melanoma.

Physical Examination

Appearance of the Patient

• Patients with uveal melanoma usually appear normal.

Vital Signs

• Patients with uveal melanoma usually present with normal vital signs.

Skin

• Skin examination of patients with uveal melanoma is usually normal.

• Skin nevus or melanoma

HEENT

• Evidence of trauma
• Pupils reactive to light / reactive to accommodation
• Ophthalmoscopic exam may be abnormal with findings of :
  • Iris melanoma:
    • Circumscribed nodule mostly in the inferior half of the iris
    • Different in size
    • Yellow or brown in color
    • It may be diffuse
  • Chroidal melanoma:
    • Nodular mass under the retinal pigment
    • It can be diffuse with less elevation
    • We may see abnormal vascularization
  • Ciliary body melanoma:
    • Sentinel vessel
    • Unilateral low intraocular pressure

Neck

• Neck examination of patients with uveal melanoma is usually normal.

Lungs

• Pulmonary examination of patients with uveal melanoma is usually normal.

Heart

• Cardiovascular examination of patients with uveal melanoma is usually normal.

Abdomen

• Abdominal examination of patients with uveal melanoma is usually normal.

Back

• Back examination of patients with uveal melanoma is usually normal.

Genitourinary

• Genitourinary examination of patients with uveal melanoma is usually normal.

Neuromuscular

• Neuromuscular examination of patients with uveal melanoma is usually normal.

Extremities

• Extremities examination of patients with uveal melanoma is usually normal.