Lacrimal drainage apparatus melanoma remotely following treatment and resolution of conjunctival melanoma

ABSTRACT

Lacrimal drainage apparatus melanoma is a rare entity that may arise primarily or, more commonly, as secondary involvement from melanoma originating elsewhere. Conjunctival melanoma may involve the lacrimal drainage apparatus (LDA) via spread along the canalicular epithelium, separate in situ processes, or direct invasion. Only seven cases exist in the literature where conjunctival melanoma remotely recurred in the LDA. We report three additional patients, two with invasive conjunctival melanoma and one with primary acquired melanosis (PAM) with severe atypia/melanoma in situ, who developed LDA melanoma at 5, 8, and 16 years after initial treatment of conjunctival melanoma. This report confirms the ability of conjunctival melanoma to give rise to spatially and temporally remote LDA melanoma despite adequate local treatment, and reviews the proposed mechanisms and associated characteristics of LDA recurrence in conjunctival melanoma.

KEYWORDS:

• Conjunctiva
• lacrimal drainage apparatus
• lacrimal sac
• LDA
• melanoma

Proprietary interest statement

None of the authors have relevant financial relationships with commercial interests.

Ethics

The Institution Review Board approval was waved for this retrospective case report study. The study was performed in compliance with the tenets of Declaration of Helsinki..