This 25YO female presented with a classic asymptomatic solitary congenital hypertrophy of the RPE (CHRPE). It almost resembles a fist!
The borders are well demarcated, with variable coal-black coloration and lacunae of depigmentation.
Learning Points:
Although CHRPE lesions can enlarge with time (see Shields et al, Ophthalmology 2003;110:1968-1973), they carry virtually no malignant potential. Histologic RPE hypertrophy has several clinical presentations.
The typical isolated CHPRE lesions (today’s post) 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.
