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

• Main Authors: Michael Chang, Sara E Lally, Lauren A Dalvin, Marlana M Orloff, Carol L Shields
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2019-01-01
• Series: Indian Journal of Ophthalmology
• Subjects: checkpoint inhibitor; conjunctiva; eye; melanoma; tumor
• Online Access: http://www.ijo.in/article.asp?issn=0301-4738;year=2019;volume=67;issue=12;spage=2071;epage=2073;aulast=Chang

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.