Recurrent Diffuse Conjunctival Malignant Melanoma.​ Extending onto cornea, and inferior palpebra​ Right Eye

  

A patient with a previous history of redness and pain in the right eye, for about 2 years. Two months prior presentation, the patient had a Pterygium/Conjunctival lesion excision in the right eye, the biopsy was positive for conjunctival melanoma. The exam was notable for a BCVA of 20/20 both eyes, the right eye presented with evident protruding area of 3x2mm with melanocytic pigmentation in the lower lid surface. Conjunctiva with multiple areas of melanocytic pigmentation at 3 o'clock, 5 o’clock, 7 o'clock and from 9 o'clock to 11 o'clock with an evident feeder vessel. There was an elevated lesion at 8 o'clock with vascularization and melanocytic pigmentation, encroaching the cornea from at 9 o'clock to at 10 o'clock. Management options were extensively discussed and the decision of excision, cryotherapy, and Radiation brachytherapy with Iodine-125 Plaque was made. During the following 3 years an effective tumor control without signs of recurrence was archived and the patient maintained a stable VA of 20/30. After the third year the patient reported a significant decreased in VA, and was diagnose with a mature cataract. She underwent cataract extraction and intraocular lens implant without complications using the White punction technique and her vision is resorted to 20/30.

Presentation Date: 10/03/2024

Issue Date: 11/20/2024