Panophthalmitis with acute scleral necrosis after brachytherapy of a malignant melanoma of the ciliary body.

Abstract

A 52-year-old man who presented with a large ciliochoroidal malignant melanoma was treated by application of a 106Ru plaque. At 8 days after removal of the plaque, severe panophthalmitis with rapidly progressive scleral necrosis at the site of the tumor made enucleation inevitable because of impending perforation of the globe. Microscopic examination revealed an intense inflammatory response and almost complete necrosis of the tumor and overlying sclera. Possible mechanisms for the occurrence of this rare complication are discussed.