Primary orbital melanoma masquerading as vascular anomalies

Abstract

Purpose To review two cases of primary orbital melanoma presenting like orbital vascular anomalies. Methods Retrospective review of clinical presentation, treatment, radiology and pathology for two patients under the care of the Orbital Clinic at Moorfields Eye Hospital. Results Both lesions presented with the appearance and behaviour of vascular anomalies. In one case, a spindle cell melanoma appeared to be a low flow vascular anomaly with a loculated secondary haemorrhage and, in the other case, a melanoma of soft parts was considered to be an arteriovenous malformation and responded partially to embolisation. Conclusion Primary malignant melanoma may present as a secondary vascular lesion of the orbit and this very rare tumour should be considered in the differential diagnosis of any vascular anomaly.

Orbital melanoma with calcification: A diagnostic dilemma

“…However, it may present as orbital varix,[ 2 ] orbital inflammatory pseudotumor,[ 3 ] eyelash poliosis,[ 4 ] meningioma,[ 5 ] or an orbital vascular anomaly. [ 6 ]…”

Melanoma-Associated Spongiform Scleropathy in Oculodermal Melanocytosis with Primary Orbital Melanoma

“…Of 33 patients with primary orbital melanoma reported in the literature up to 2002, 27 cases (82%) arose in the context of either oculodermal melanocytosis or blue nevus type of malformation [7,8] . In our patient, the orbital melanoma was found adjacent to benign melanocytes, the presumed cells that spawned the malignancy.…”

Periocular Hemangiomas: What Every Physician Should Know

“…Periorbital hemangiomas require neuroimaging and must be differentiated from other types of vascular malformations as well as from malignancies like rhabdomyosarcoma, neuroblastoma, or primary orbital melanoma (30). Many types of imaging can be useful in diagnosing periorbital hemangiomas, although the preferred type, in our experience as well as that of others, is magnetic resonance imaging (MRI) with gadolinium contrast (31).…”