Fig. 7
An 82-year-old man with a choroidal melanoma of the left eye treated with plaque brachytherapy. The patient underwent secondary enucleation seven years after radiotherapy because of painful eye and local recurrence. Axial a T2-weighted turbo spin-echo STIR and b fat-suppressed T1-weighted images. Along the medial aspect of the left globe an intraocular mass (arrows) exhibits inhomogeneous signal intensity with irregularly edged hypointense areas on T2-weighted image (white arrowhead in a), due to radiation-induced fibrotic alterations. The anterior chamber and the vitreous body of the left eye demonstrate high signal intensity on T1-weighted image (black asterisk in b), a finding consistent with extensive vitreous hemorrhage. Note the difference with the physiological water-like signal intensity of the contralateral eye. c Histological low magnification showing the heterogeneous appearance of the tumor, composed of poorly pigmented spindle cells, intermingled with dense and eosinophilic intratumoral fibrotic areas (H&E, original magnification 25×). d On higher magnification, the fibrotic nature of the above-described eosinophilic areas is well documented: neoplastic spindle cells are mixed to multiple deposits of dense collagen fibres, representing the main effect of radiotherapy (H&E, original magnification 100×)