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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
Summary
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.
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