This is a picture of a classic solitary congenital hypertrophy of the RPE (CHRPE). The borders are well-demarcated with a variable coal-black coloration.
With age, they often develop multiple hypopigmented lacunae that tend to enlarge over time. The CHRPE lesions can also enlarge with time, but carry virtually no malignant potential.
Learning Points:
Histologic RPE hypertrophy presents in several ways. The typical isolated CHPRE lesions and bear tracks are not associated with intestinal polyps or cancer, and thus require no systemic evaluation. Only the multiple, small comet-shaped lesions are part of the familial polyposis spectrum.
