Malignant melanoma of the lacrimal sac

A 79-year-old man with a bloody ocular discharge and a mass above the medial canthal tendon was found to have a malignant melanoma of the lacrimal sac. Because he refused radical surgery, he was treated with radiotherapy and chemotherapy. Within a year the tumor had spread to his palate and cervical nodes. Because of the uncommon occurrence of melanoma in the lacrimal area and the fact that the microscopic appearance may resemble other malignancies, special stains are necessary for identification to implement the appropriate therapy.