为描述一位女性的案例，她在观察先前治疗的脉络膜痣19年后，突然发展为迅速恶化脉络膜黑色素瘤。这位71岁的女性患有22年历史的脉络膜痣，在接受经瞳孔治疗热疗后，观察了19年，治疗针对局限性、累及黄斑的渗出性视网膜脱离。在她最近的稳定检查五个月后，她前来接受常规随访。病变已经增厚，并伴有脂肪酸和视网膜下液，提示恶性转化的可能性。在诊断与使用Iodine-125 plaque brachytherapy治疗之间的1个月内，病变继续扩展，需要调整放射剂量。脉络膜痣转变成黑素瘤已得到充分记录，强调了需要定期随访的必要性。通常，在1个月内的治疗足以达到适当的管理。偶尔，黑色素瘤在诊断和治疗之间可能会大幅增长，这表明在极少数情况下需要重复测量，以确保适当的放射治疗。

To describe the case of a woman who developed rapid progression of a choroidal melanoma after 19 years of observation of a previously treated choroidal nevus.A 71-year-old woman with a 22-year history of a choroidal nevus was observed for 19 years after undergoing transpupillary thermotherapy for a localized, macula-involving, exudative retinal detachment. Five months after her most recent stable examination, she presented for routine follow-up.The lesion was noted to have increased thickness with development of lipofuscin and subretinal fluid, suggestive of malignant transformation. In the 1 month between diagnosis and treatment with Iodine-125 plaque brachytherapy, the lesion continued to expand, requiring a radiation dose adjustment.Choroidal nevus transformation into melanoma has been well-documented, highlighting the need for routine follow-up. Treatment within 1 month is typically sufficient for appropriate management. Occasionally, melanomas may grow substantially between diagnosis and treatment, suggesting that repeat measurement may be necessary in rare instances to ensure appropriate radiation treatment.