Metastasis of choroidal melanoma to the contralateral choroid, orbit, and eyelid

A 52-year-old woman was found to have a small juxtapapillary pigmented lesion in the choroid of the left eye. This lesion remained clinically stationary for one year, but subsequent growth prompted enucleation of the eye. The tumour was diagnosed histologically as a choroidal malignant melanoma of mixed cell type. Approximately 52 months later the patient developed proptosis of the contralateral (right) eye. Orbital ultrasonography showed a large mass in the right orbit, which was confirmed by needle biopsy to be a melanoma. In addition the patient was found to have metastatic melanoma to the choroid, right lower eyelid area, and liver. The development of simultaneous orbital, choroidal, and eyelid metastases from a contralateral choroidal melanoma is of ophthalmic interest and appears to be unique.