Primary Uveal Melanoma Metastasizing to the Intraconal Space of the Contralateral Orbit: A Case Report

Abstract

Objective. We present an extremely rare case of primary uveal melanoma (PUM) metastasizing to the intraconal space of the contralateral orbit without involving the liver.

Case summary. This is a case of a 66-year-old woman who underwent enucleation of the right eye for an intra ocular mass five years prior to consult and had a histopathologic diagnosis of spindle cell melanoma. She had no skin lesions nor distant metastasis on systemic work-up. Five years later, she came back for gradual loss of vision in the left eye associated with eye pain and progressive proptosis from a intraconal orbital mass. Excision biopsy of said mass revealed an epithelioid cell melanoma. Again, she has no skin lesions nor liver involvement.

Conclusion. PUM metastasizing to the intraconal space of the contralateral orbit without liver involvement as seen in our patient is exceedingly rare. Despite differences in the histopathologic characteristics, the orbital melanoma was presumed to be metastasis due to the rarity of a second primary and its delayed presentation compared to the PUM.