Choroidal Metastasis Presenting As Anterior and Posterior Scleritis: A Rare Manifestation of a Previously Unknown Metastatic Cutaneous Melanoma.

Choroidal metastasis from occult cutaneous melanoma is rare and can masquerade as ocular inflammation. A 70‑year‑old man with sectoral anterior scleritis was found on multimodal imaging to have a solitary choroidal mass with mild periscleral fluid, prompting systemic evaluation that uncovered colonic polyps that, on histopathology, contained metastatic melanoma, a scalp primary, and widespread visceral, nodal, and intracranial metastases. Tumour cells stained HMB‑45, Melan‑A, and SOX10 positive, AE1/AE3 negative, and carried an NRAS‑Q61 mutation with wild‑type BRAF, confirming cutaneous origin. Combined immune‑checkpoint blockade and ocular‑plus‑cerebral radiotherapy preserved Snellen visual acuity of 20/50-2 (≈0.44 logMAR) in the affected eye, although systemic disease progressed four months later. This case highlights the importance of meticulous fundus examination, multimodal imaging, and molecular profiling for distinguishing metastatic choroidal melanoma from primary uveal melanoma when ocular inflammation obscures malignancy, thereby enabling timely, targeted therapy.