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Eye-Sparing Treatment for Diffuse Invasive Conjunctival Melanoma

Leandro J Chaves1, Bradley Huth2, James J Augsburger3

  • 1Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.

Ocular Oncology and Pathology
|January 16, 2019
PubMed

Insights

This study presents a favorable outcome for a patient with invasive conjunctival melanoma and lymph node involvement. Treatment involved debulking, brachytherapy, and ipilimumab, showing no relapse or metastasis after 16 months.

Area of Science:

  • Ophthalmology
  • Oncology

Background:

  • Diffuse invasive conjunctival melanoma management prioritizes local control and metastasis screening.
  • Sentinel lymph node biopsy lacks consensus but aids staging.
  • Orbital exenteration is decreasing due to limited survival benefit evidence.

Purpose of the Study:

  • To report a case of conjunctival melanoma with lymph node involvement.
  • To describe a multimodal treatment approach and its outcome.

Main Methods:

  • Tumor debulking surgery.
  • Brachytherapy using a custom unshielded radioactive device.
  • Adjuvant ipilimumab therapy.

Main Results:

  • Favorable outcome in a patient with conjunctival melanoma and lymph node metastasis.
  • No local tumor relapse observed during 16 months of follow-up.
  • No distant metastasis detected during 16 months of follow-up.

Conclusions:

  • Multimodal treatment including debulking, brachytherapy, and ipilimumab can be effective for invasive conjunctival melanoma with lymph node involvement.
  • This approach may offer a favorable prognosis without local recurrence or distant spread.
Keywords:
BrachytherapyEnucleationMelanoma, conjunctivaMelanoma, eye

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