A 50 year old white male presented for a standardized echography evaluation, following retinal examination and diagnosis of a uveal melanoma. Echographic findings revealed a 5.3 mm dome shaped lesion, in the temporal anterior equator region of the right eye, consistent with uveal melanoma. The patient refused treatment and/or enrollment into the Collaborative Ocular Melanoma Study due to 'personal problems'. Further attempts to provide treatment were refused by the patient, due to his desire to treat the tumor by following a herbal and macrobiotic diet regimen. The patient presented five months later with the complaint of a sensation of a 'corn husk' in his eye and epiphora. Examination revealed severe proptosis, chemosis, erythema of the lids and a steamy, hazy cornea. Standardized echography revealed a massive lesion involving the entire posterior segment of the globe with elevation of approximately 21.5 mm and extraocular extension. Following enucleation, the gross pathologic specimen reveals multiple extraocular nodules, confirmed histopathologically.