Conjunctival Melanoma Metastasis to the Contralateral Orbit

Background: Malignant melanoma predominantly occurs in whites, and is potentially fatal. Distant metastases often occur in lung, liver, brain, and could occur without prior regional disease. Conjunctival melanoma metastasis to contralateral orbit has never been reported. Patient Presentation: A 60-year-old man who underwent a left primary conjunctival neoplasm resection 11 months ago presented for the evaluation of a conjunctival dark-colored mass with a bulging left lower eyelid that directly invaded the orbits bilaterally. A histopathologic examination and immunohistochemistry confirmed metastases from conjunctival melanoma. In addition, the contralateral orbit had metastases without local recurrence after surgery within the authors' department. The patient was given adjuvant therapy (vincristine + nedaplatin + dacarbazine) for 5 cycles, but he died 8 months after surgery. Conclusion: Malignant conjunctival melanoma may metastasize to the contralateral orbit. A histopathologic evaluation should be mandatory in patients with medical histories of malignancy to differentiate new primary tumors, metastases, and benign tumors. Address correspondence and reprint requests to Renbin Jia, MD, PhD, Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhi Zao Ju Road, Shanghai 200011, China; E-mail: xiaoxiao.870411@163.com Received 13 March, 2018 Accepted 15 April, 2018 FH and YW contributed equally to this paper. The article is supported by The Science and Technology Commission of Shanghai (17DZ2260100). The authors report no conflicts of interest. © 2018 by Mutaz B. Habal, MD.

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