Systemic cardiac migration of perfluorocarbon liquid following unsuccessful endoresection of choroidal melanoma: a case report.

Abstract

Choroidal melanoma (CM) is the most common intraocular malignant tumor in adults, with a high rate of metastasis and mortality. This study reports a case of systemic cardiac migration of perfluorocarbon liquid (PFCL) following an unsuccessful endoresection of CM. A 61-year-old woman underwent gamma knife radiosurgery and pars plana vitrectomy endoresection for CM in her left eye. The procedure was complicated by intraocular bleeding, leading to incomplete tumor removal, with the eye filled with PFCL and blood before closure. The patient refused further surgery and later developed secondary glaucoma. Nearly three years later, during an acute increase in intraocular pressure reaching 50 mmHg, she experienced severe respiratory insufficiency requiring intubation and veno-arterial extracorporeal membrane oxygenation (V-A ECMO). Echocardiography showed a severely dilated right ventricle and echogenic material in the left atrium and ventricle, while acute coronary syndrome and pulmonary embolism were ruled out. The patient's respiratory status stabilized, and intracardiac echogenic material was observed during the first three days of V-A ECMO but was absent afterward. In summary, cardiac PFCL migration can occur after endoresection for choroidal melanoma; therefore, specific precautions should be taken to prevent and promptly detect this complication.