Bindehautmetastase eines primären Hautmelanoms

Abstract

Case report of a metastatic carcinoma of the conjunctiva originating in a cutaneous superficial spreading melanoma. Conjunctival metastasis as well as dissemination of skin melanomas to the eye are extremely rare events. As to our knowledge until now, there is no documentation of a cutaneous malignant melanoma metastatic to the conjunctiva.

Metastatic tumours to the conjunctiva: report of 10 cases.

“…26 Concomitant other systemic metastases were present in 80% and other ocular metastases in 80% of our patients. This is similar to other reports.14-20 22 Interestingly, the most common associated ocular metastatic site was iris in 60% and the most common non-ocular site was subcutaneous tissues in 50% of our patients. This trend was not observed in previous reports.…”

“…25 In a series of metastatic tumours to the eyelid,24 the lid lesions were detected before the primary focus in 45% of the cases and likewise metastatic tumours to the orbit have been found in 26% to occur before the discovery of the primary tumour.26 Concomitant other systemic metastases were present in 80% and other ocular metastases in 80% of our patients. This is similar to other reports.14-20 22 Interestingly, the most common associated ocular metastatic site was iris in 60% and the most common non-ocular site was subcutaneous tissues in 50% of our patients. This trend was not observed in previous reports.…”

“…One patient was receiving chemotherapy for the widespread systemic disease at the time of ocular diagnosis. Two Although uncommon, ocular metastases from cutaneous melanoma have been well documented.72021 Interestingly, most of the reported patients had their previously diagnosed primary cutaneous melanoma on their truncal skin and the primary lesions were classified as superficial spreading melanoma.7 21 22 Jakobiec et al 7 reported five patients with conjunctival metastases that appeared 3 months to 1 year after the excision of the primary skin melanoma. The two patients with cutaneous melanoma in our series also had their primary neoplasm on their truncal skin but were classified as lentigo maligna Clark level 2 (patient No 5) and nodular types (patient No 6), and they metastasised to the conjunctiva after 71 months and 15 months respectively.…”

“…Mansour and Hidayat24 reported three patients with tarsal and palpebral conjunctival metastatic lesions but the majority of the reported cases suggest that the most common site of metastasis is the bulbar conjunctiva.14-17 19 22 Review of the literature shows that most of the conjunctival metastases are solitary lesions with dilated overlying conjunctival vessels and not adherent to the underlying sclera.14-17 19 22 Our findings are in concert with these observations; however, we did not encounter metastatic tumours with ulcerated surfaces protruding through the palpebral fissure with serosanguineous discharge that was reported in other cases. [16][17][18] All of our patients had a known primary malignant tumour before the diagnosis of the conjunctival metastasis except one (No 10).…”

Conjunctival Metastasis of a Cutaneous Melanoma

“…An overview of 19 conjunctival metastases of cutaneous melanomas showed a poor survival, ranging from <1 to 16 months [11]. However, it has to be noted that survival data in 5 out of 19 reported cases were absent [2,10,12,13,14,15,16,17,18,19,20]. …”