Marsupialized Fungal Mycetoma Masquerading as Conjunctival Melanoma

Purpose: To report a case of a fungal mass misdiagnosed as a pigmented conjunctival melanoma. Method: Case report. Result: A 38-year-old woman was referred for a pigmented conjunctival lesion that was diagnosed as a melanoma. She had a history of a scleral buckle in that eye for retinal detachment 2 years before presentation. Slit-lamp examination revealed a pigmented mass from the 11- to 2-o'clock position. This was noted to be imbricated within the invagination of a conjunctival fold from the previous surgery. The mass was removed, cultured, and confirmed to be a fungal infection from Scytalidium sp. Conclusions: Scleral buckles can cause folds in the conjunctiva, which can be foci for fungal infection.

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