Retrograde Metastasis of Cutaneous Melanoma to Conjunctival Lymphatics

Shields, Jerry A.

doi:10.1001/archophthalmol.2009.218

Cited by 5 publications

(3 citation statements)

References 9 publications

(14 reference statements)

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“…Rarely, abnormal conjunctival pigmentation mimicking primary CM can occur in patients with a prior diagnosis of cutaneous melanoma. Reports documenting conjunctival metastasis have included patients with cutaneous melanoma arising at both distant (trunk [22, 23], axilla [24], scapula [25], vaginal mucosa [26]) and local (pre-auricular [27], temple [28], neck [29]) sites. Conversely, there have been rare reports of primary CM metastasizing to the eyebrow and cheek [30]; however, it is unclear whether or not the histopathological findings in these patients were consistent with in-transit metastasis or not.…”

Section: Discussionmentioning

confidence: 99%

“…In-transit metastasis occurs in up to 4% of cases of cutaneous melanoma and is a phenomenon attributed to intralymphatic spread resulting in a second lesion >2 cm from the primary tumour but not beyond the regional nodal basin [31]. While conjunctival metastasis from cutaneous melanoma typically occurs via haematogenous routes, Shields et al [27] reported a very peculiar case of retrograde conjunctival metastasis via lymphatic channels of a cutaneous melanoma arising in the pre-auricular skin.…”

Section: Discussionmentioning

confidence: 99%

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Conjunctival Melanoma with Ipsilateral, Non-Contiguous Eyelid Involvement: A Case Report and Comprehensive Review of the Literature

2020

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• Concurrent pigmentation of the ipsilateral eyelid can occur in up to 15% of cases of conjunctival melanoma. • While conjunctival melanoma may extend into the eyelid in 1% of cases (AJCC cT3b), cases of noncontiguous conjunctival melanoma and eyelid melanoma are very rare with only 5 clearly documented reports in the English literature. Novel Insights • We report a rare case of conjunctival melanoma with non-contiguous eyelid melanoma and provide a comprehensive review of the literature. • This case highlights the importance of long-term follow-up for patients diagnosed with conjunctival melanoma as some instances of secondary eyelid involvement occur several years following the initial diagnosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Conjunctival Melanoma with Ipsilateral, Non-Contiguous Eyelid Involvement: A Case Report and Comprehensive Review of the Literature

2020

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“…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]. …”

Section: Discussionmentioning

confidence: 99%

Conjunctival Metastasis of a Cutaneous Melanoma

Brouwer

Marinković

Jochems³

et al. 2017

Ocul Oncol Pathol

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Purpose: To report a patient who presented with a conjunctival tumour as a first sign of distant metastasis of cutaneous melanoma. The patient was treated successfully with BRAF/MEK-inhibitors and anti-PD-1 antibodies. Methods: Clinical and histopathological examination of the conjunctival lesion. Results: A 74-year-old man was referred to our hospital with a pigmented conjunctival tumour, 5 months after having been diagnosed with cutaneous melanoma on his right scapula with loco-regional axillary lymph node metastases. The conjunctival lesion was excised and showed a BRAF V600E mutation. Histopathology showed a melanoma with characteristics suspicious for metastasis, as the lesion did not have a relation with the overlying epithelium. Systemic screening showed multiple distant metastases of the cutaneous melanoma in spleen, liver, and bone. Systemic treatment with the combination of a BRAF-inhibitor (dabrafenib) and MEK-inhibitor (trametinib) was started and followed by a switch to an anti-PD-1 antibody (pembrolizumab). Twenty-two months later, the patient is alive and in good clinical health. Conclusion: Conjunctival metastases of cutaneous melanoma may mimic primary conjunctival melanoma. A good medical history and systemic work-up are required to differentiate these diseases. Identification of the proper diagnosis including mutation analysis is crucial, allowing patients to benefit from newly introduced treatment strategies for metastatic cutaneous melanoma.

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