Two darkly pigmented patients with a diagnosis of conjunctival melanoma by an outside provider are presented here. Case 1 presented with a large jet black conjunctival lesion that was present for nearly 12 years. This lesion was biopsied by an outside provider and interpreted to be conjunctival melanoma. The patient underwent wide excision with cryotherapy. Final pathology of the lesion was consistent with tumoral melanosis in a background of a combined compound nevus (nevocellular and blue nevus). Case 2 presented with a small pigmented lesion near the caruncle which was consistent with invasive melanoma. Review of outside specimens confirmed this diagnosis. Ultimately, patient failed nivolumab/ipilimumab therapy with local tumor spread into the orbit requiring exenteration. The patient is now receiving adjuvant radiotherapy, without any evidence of metastatic disease.
Presentation Date: 03/30/2023
Issue Date: 04/14/2023