Choroidal melanoma, clinical appearance. A, B, Choroidal melanomas may be quite thin. Note the prominent surface lipofuscin in each case and the large area of flat involvement surrounding the elevated portion centrally in part B (arrowheads); however, they are more commonly elevated (>2 mm in height). Melanomas are usually pigmented (A, B, E, F) or, less commonly, amelanotic (C, D). Smaller melanomas typically have a dome shape, whereas larger tumors that have broken through Bruch membrane have a collar-button configuration (D, E). This is often accompanied by subretinal hemorrhage (D, arrowheads). F, Retinal invasion and vitreous seeding of a tumor may occur, with seeding seen as a dark streak (arrowheads). G, H, Very large tumors may be associated with large serous retinal detachments. In part G, the tumor apex is darkly pigmented (asterisk), and the retinal detachment is seen at the lower left (arrowheads).