Ocular melanoma is a rare malignancy arising from melanocytes of the uvea, the conjunctiva, and the orbit. Uveal melanoma is the most common intraocular malignancy in adults, accounting for 85-95% of ocular melanomas [1-3]. The conjunctival form accounts for 5% of ocular melanomas. Uveal and conjunctival melanoma are very distinct from each other biologically. We describe a case of conjunctival melanoma and a uveal melanoma both presenting as large masses of the anterior segment.
75 year old female from Haiti presented with spontaneous bleeding from her left eye for 1 day. She had a black mass present on the surface of her left eye which was noted by her family 4 months prior when she arrived from Haiti. The patient did not seek any medical care until bleeding began. She did not complain of pain. She denied past ocular trauma or surgery or a history of anticoagulation therapy. On examination, vision was 20/40 in the right eye, light perception in the left eye. The right pupil was reactive. The mass prevented the visualization of the left pupil. In the left eye, there was 3+ diffuse conjunctival injection, and a large black and somewhat bloody mass measuring 12x12x4mm that precluded visualization of the entire cornea and anterior segment (Figure 1A). Computed Tomography (CT) scan demonstrated a formed and normal sized globe with a solid mass overlying an intact cornea.
Published on: Dec 3, 2016 Pages: 41-43