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Uveal melanoma (UM) is the most frequent intraocular tumor in adults with an annual incidence of about 6/1.000.000. Despite successful treatment of the primary tumor in most cases, approximately 50% of patients die from metastases within 15 years after treatment. This proportion has remained constant during the last decades.

Standardized echography can detect and differentiate intraocular tumors with a great accuracy. However, these tumors may present atypical characteristics. Here we describe a patient with a black mass on the skin of his nose, and retinal detachment due to a solid lesion in his left eye. The echographic characteristics of this lesion and the differential diagnosis with other tumors are discussed.

Leukokoria, a white pupillary reflex, is an important clinical sign in ophthalmology since it is the most common presenting sign of retinoblastoma, a highly malignant pediatric intraocular tumor. Numerous simulating conditions need to be distinguished from retinoblastoma in order to insure prompt recognition and appropriate treatment of all conditions. The majority of cases can be diagnosed through careful clinical examination and correlation with pertinent historical data. Unfortunately, in approximately 20% of cases a secure diagnosis cannot be established through standard clinical techniques, and in these patients ancillary diagnostic testing is extremely valuable.