Conjunctival Melanoma with Intraocular Extension

A 40-year-old woman noted fullness of her right upper eyelid for 3 months (Fig A). She had a history of recurrent conjunctival melanoma with multiple excisions over 7 years. One year earlier, she had unrelated filtering surgery for elevated intraocular pressure. Orbital biopsy confirmed the diagnosis of melanoma, and she underwent orbital exenteration. The specimen demonstrated orbital and intraocular extension of conjunctival melanoma (Fig B) with replacement of the choroid (Fig C) and retina (Fig D) with melanoma cells.