Palpebral cutaneous melanomas: a review of 17 cases from a tertiary center

Melanomas arising from eyelid skin are exceptionally rare, accounting for <1% of eyelid malignancies and all cutaneous melanomas. The aim of this study was to identify the histopathological features and clinical behaviors of the palpebral skin melanoma patients from a single tertiary institution.

Seventeen Caucasian patients diagnosed with eyelid cutaneous melanoma were analyzed retrospectively.

The median age of patients was 59 years, and females were predominant (n = 11). The most frequent localization of the lesions was the lower eyelid (n = 8). Nodular (n = 4), lentigo maligna (n = 3), and the superficial spreading melanoma (n = 3) were the most common histopathological subtypes. Only three patients had in situ melanomas. Tumor infiltrating lymphocytes were present in most of the patients; however, only a few cases had lymphovascular invasion. Regional lymph node involvement was present in two patients, and distant metastasis was found in only one patient. Four patients (24%) had disease relapses during follow-up, all of which were locoregional. The median relapse-free survival (RFS) time and 5-year RFS rate were 26.3 months and 60.4%, respectively. Two patients (12%) died. Median OS time was 32.1 months, and 5-year OS rate was 84%. Being elderly (older than 60 years of age) (P = 0.05), lesion originating from canthus compared to eyelid (P = 0.03) and presence of recurrence in follow-up (P = 0.04) have been found as poor prognostic indicators for OS.

Palpebral skin melanoma is associated with favorable clinical features, and it is correlated with better survival rates.