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Updated: Aug 9, 2025
Murine Corneal Transplantation: A Model to Study the Most Common Form of Solid Organ Transplantation
Published on: November 17, 2014
Conjunctival melanoma following cornea transplant from a cancer donor: A case report
Sergio Kwitko1,2, Samara Barbara Marafon1,2, Mariana Fernandez Simao1
1Ophthalmology Department of Hospital de Clinicas de Porto Alegre, 2350 Ramiro Barcelos St, Room 17 B1, Porto Alegre, RS, 90035-007, Brazil.
Purpose:
Conjunctival melanoma is a rare ocular tumor. We report a case of ocular conjunctival melanoma during topical immunosuppression, after a corneal transplant from a donor with metastatic melanoma.
Observation:
A 59-year-old white male presented with a progressive nonpigmented conjunctival lesion in his right eye. He had previously undergone two penetrating keratoplasties, and he was being treated with topical immunosuppression with 0.03% tacrolimus (Ophthalmos Pharma; Sao Paulo, SP/Brazil). The histopathology evaluation revealed the nodule to be a conjunctival epithelioid melanoma. The donor's death cause was disseminated melanoma.
Conclusion And Importance:
The correlation between cancer and systemic immunosuppression after a solid organ transplant is widely known. The local influence, however, has not been reported. In this case, a causal relationship was not established. The correlation between conjunctival melanoma, exposure to topical tacrolimus immunosuppressive therapy, and the malignance characteristic of donor cornea should be better evaluated.
Insights
This case highlights a rare conjunctival melanoma in a patient receiving topical immunosuppression post-corneal transplant. The donor cornea had metastatic melanoma, suggesting a potential link requiring further investigation.
Area of Science:
- Ophthalmology
- Oncology
Background:
- Conjunctival melanoma is an uncommon ocular malignancy.
- Corneal transplantation involves replacing diseased corneal tissue with donor tissue.
- Topical immunosuppression is frequently used post-transplant to prevent graft rejection.
Observation:
- A 59-year-old male developed a nonpigmented conjunctival lesion after two corneal transplants.
- The patient was undergoing treatment with topical tacrolimus for immunosuppression.
- The donor cornea was found to be from a patient with disseminated melanoma.
Findings:
- Histopathology confirmed the conjunctival lesion as an epithelioid melanoma.
- The study presents a unique instance of conjunctival melanoma in the context of corneal transplantation and immunosuppression.
Implications:
- This case suggests a potential, though unproven, correlation between topical immunosuppression, donor cornea malignancy, and the development of conjunctival melanoma.
- Further research is warranted to evaluate the relationship between topical immunosuppressants like tacrolimus and the risk of secondary malignancies in ocular transplant recipients.
- The findings underscore the importance of donor screening and careful patient monitoring in post-keratoplasty care.
