[Triple malignancy in a patient with conjunctival melanoma]

A 73-year-old male with a history of bladder carcinoma presented with conjunctival melanoma that was excised. Multiple lung metastases were detected during diagnostic work-up. Because of uncertainty about the histology of the metastatic lung tumor, a biopsy was performed that revealed a third primary non-small cell carcinoma of the lung. This case illustrates the need to obtain histological verification in patients with conjunctival melanoma and distant metastases, especially if metastases are detected early in the follow-up.