Melanomas usually metastasize through the lymphatic route. However, choroidal melanoma invariably disseminates hematogenously to the liver. Liver metastasis develops in approximately two thirds of patients with recurrent uveal melanoma. The PET scan is a sensitive tool for the detection and localization of hepatic and extrahepatic metastatic choroidal melanoma. We report a patient with a history of choroidal melanoma in the left eye. The patient had undergone a scleral plaque placement followed by an enucleation and an implant. He was referred to us for a PET scan for restaging. No prior PET scan was available for comparison. An implant in the eye with intense FDG-avid liver metastasis should raise suspicion of choroidal melanoma.
