Pediatric focally pigmented choroidal melanoma: Imaging with pathological correlation

We report a 9-year-old-boy with no predisposing factors who presented with left eye leukocoria from a complete retinal detachment at ophthalmoscopy. Imaging showed an intraocular dome-shaped mass of low to moderate internal reflectivity at ultrasound, low T2-weighted signal intensity, lack of T1-weighted high signal intensity, and subtle gadolinium-enhancement at magnetic resonance imaging, and lack of calcifications at computed tomography. Due to the rapid extensive intraocular growth, the affected eye was enucleated. Pathologic examination showed a choroidal melanoma with only focal pigmentation. Despite its very rare incidence in the pediatric population, choroidal melanoma should be included in the differential diagnosis of leukocoria.