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Indian J Ophthalmol. 2019 Dec;67(12):2071-2073. doi: 10.4103/ijo.IJO_663_19.

Conjunctival melanoma with orbital invasion and liver metastasis managed with systemic immune checkpoint inhibitor therapy.

Author information

1
Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA, USA.
2
Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA; Department of Ophthalmology, Mayo Clinic, Rochester, MN, USA.
3
Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, USA.

Abstract

A 60-year-old Caucasian female was referred for biopsy-proven amelanotic orbito-conjunctival melanoma. Map biopsies revealed residual invasive melanoma on the deep tarsal margin at the site of previous surgery. Repeat excisions were required after recurrence was detected following 3 months and 7 months. Positron emission tomography scan detected liver metastasis and additional orbito-conjunctival melanoma recurrence. Biomarker testing showed NRAS mutation without BRAF or c-KIT mutations and without PD-L1 expression. Systemic checkpoint inhibitor therapy was initiated with regression of both the orbito-conjunctival melanoma and liver metastasis. Invasive, non resectable orbito-conjunctival melanoma with liver metastasis can demonstrate a response to systemic checkpoint inhibitor therapy.

KEYWORDS:

Checkpoint inhibitor; conjunctiva; eye; melanoma; tumor

PMID:
31755463
DOI:
10.4103/ijo.IJO_663_19
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