Título / Title

PARANEOPLASTIC VITELLIFORM RETINOPATHY ASSOCIATED NASAL TURBINATE MELANOMA

Introdução / Purpose

The most frequent causes of vitelliform lesions are Age-related Macular Degeneration and Adult-onset Foveomacular Vitelliform Dystrophy. However, vitelliform deposits could be part of paraneoplastic spectrum.

Material e Método / Methods

Case report of nasal turbinate melanoma that developed Paraneoplastic Viteliforme Retinopathy.

Resultados / Results

A 74-year-old male presented with a 1-month history of blue spot on the central field in both eyes. He had no background of retinal or systemic diseases. His visual acuity was 20/30 in the right eye and 20/40 in the left eye. Anterior segment and intraocular pressure were normal. Fundus examination revealed bilateral, multifocal circumscribed yellow–orange vitelliform lesions in the posterior pole of both eyes. There was no evidence of neoplastic lesions in the retina. The Amsler Grid test was positive. Optical Coherence Tomography showed multiple areas of a neurosensory retinal detachment (NRD), outer retinal thickening and hyperreflectivity with subretinal fluid bilaterally. There was no evidence of subretinal neovascular membrane on OCT Angiography. The patient was referred to an oncologist who detected left nasal turbinate melanoma, 1 cm in diameter and metastasis to multiple lymph nodes.

Discussão e Conclusões / Conclusion

Paraneoplastic Viteliforme Retinopathy (PVR) is a spectrum of Melanoma Associated Retinopathy that manifests with pigment epithelial detachment (PED) and neurosensory retinal detachment (NRD) and characterized clinically by photopsia, nyctalopia and variable visual loss. It is, usually, associated with metastatic cutaneous and uvea melanoma. There is no previous reports of association with nasal turbinate melanoma. Evidence suggests that paraneoplastic retinopathies result from autoantibodies directed against tumor antigens that cross-react with retinal antigens. In summary, PVR should always be considered in patients with or without a history of melanoma with unexplained NRD, PED and/or viteliform lesions.

Palavras Chave

Paraneoplastic, Viteliforme, Melanoma