Extraocular spread of uveal melanoma to the breast: a rare clinical presentation

Uveal melanoma (UM) is a rare malignancy with a high risk of delayed metastasis, primarily to the liver. Metastatic spread to the breast is exceedingly uncommon and may mimic primary breast carcinoma, posing diagnostic challenges. We report the case of a patient with a history of UM who was found to have a new right breast lesion on surveillance magnetic resonance imaging 18 years after initial UM diagnosis. The patient underwent Strut-Adjusted Volume Implant Scout guided partial mastectomy. Histopathology of the surgical specimen confirmed metastatic UM. This case underscores the unpredictable metastatic behavior of UM and highlights the importance of maintaining clinical vigilance and a broad differential diagnosis, even decades after initial treatment.