A Peculiar Case of Cutaneous Eyelid Melanoma: Clinicopathological Questions and Therapeutic Challenges

Alin Dumitru Ciubotaru 1 , Constantin Grigoraș 2 ,  and Carmen-Ecaterina Leferman 1
  • 1 “Gr. T. Popa” University of Medicine and Pharmacy, , , Iaşi
  • 2 Saint Spiridon County Hospital, , Iași


Primary melanoma of the eyelid is a rare malignant tumour that accounts for <1% of all malignant melanomas and about 1% of malignant tumours of the eyelid. The most common clinical presentation of melanoma is an oval lesion; linear presentation is uncommon. We presented a 79-year-old woman with a several-month history of a rapidly-growing, irregular, linear, pigmented cutaneous lesion on the right lower eyelid, involving the eyelid margin. The lesion measured 2 cm x 0,8 cm x 0,2 cm. Anterior and posterior segments appeared normal in both eyes, without pathological findings on ocular ultrasound examination. After excision biopsy, histopathological examination revealed a nodular melanoma. The case underwent additional investigations for staging and therapy. The current therapeutic strategies in eyelid melanoma include surgical excision, systemic chemotherapy, immunotherapy, targeted therapy or radiotherapy. Despite advanced research methods in the field, the management of eyelid melanoma is still a major challenge.

If the inline PDF is not rendering correctly, you can download the PDF file here.

  • 1. Boulos PR, Rubin PAD. Cutaneous melanomas of the eyelid. Semin Ophthalmol. 2006 Sep;21(3):195-206.

  • 2. Higgins HW, Lee KC, Galan A, Leffell DJ. Melanoma in situ: Part I. Epidemiology, screening, and clinical features. J Am Acad Dermatol. 2015 Aug;73(2):181-90, quiz 191–2.

  • 3. Porras BH, Cockerell CJ. Cutaneous malignant melanoma: classification and clinical diagnosis. Semin Cutan Med Surg. 1997 Jun;16(2):88-96.

  • 4. Beaulieu D, Fathi R, Srivastava D, Nijhawan RI. Current perspectives on Mohs micrographic surgery for melanoma. Clin Cosmet Investig Dermatol. 2018;11:309-20.

  • 5. Silverman N, Shinder R. What’s New in Eyelid Tumors. Asia-Pac J Ophthalmol Phila Pa. 2017 Apr;6(2):143–52.

  • 6. Mattia G, Puglisi R, Ascione B, Malorni W, Carè A, Matarrese P. Cell death-based treatments of melanoma:conventional treatments and new therapeutic strategies. Cell Death Dis. 2018 25;9(2):112.

  • 7. Memarzadeh K, Engelsberg K, Sheikh R, Malmsjö M. Large Eyelid Defect Repair Using a Free Full-Thickness Eyelid Graft. Plast Reconstr Surg Glob Open. 2017 Jul 26;5(7).

  • 8. Xu Z, Shi P, Yibulayin F, Feng L, Zhang H, Wushou A. Spindle cell melanoma: Incidence and survival, 1973-2017. Oncol Lett. 2018 Oct;16(4):5091-9.

  • 9. Cohen PR. Linear Malignant Melanoma In Situ: Reports and Review of Cutaneous Malignancies Presenting as Linear Skin Cancer. Cureus. 2017 Sep;9(9).

  • 10. Greenwald HS, Friedman EB, Osman I. Superficial spreading and nodular melanoma are distinct biological entities: a challenge to the linear progression model. Melanoma Res. 2012 Feb;22(1):1-8.

  • 11. Dummer R, Brase JC, Garrett J, Campbell CD, Gasal E, Squires M, et al. Adjuvant dabrafenib plus trametinib versus placebo in patients with resected, BRAFV600-mutant, stage III melanoma (COMBI-AD): exploratory biomarker analyses from a randomised, phase 3 trial. Lancet Oncol. 2020 Jan 30.

  • 12. Rosko AJ, Vankoevering KK, McLean SA, Johnson TM, Moyer JS. Contemporary Management of Early-Stage Melanoma: A Systematic Review. JAMA Facial Plast Surg. 2017 May 1;19(3):232-8.

  • 13. Verga E, Chohan B, Verdolini R. Malignant Melanoma Treated with Topical Imiquimod: A Bespoke Treatment That Spared the Amputation. Case Rep Dermatol. 2019 Apr;11(1):1-6.

  • 14. Mendoza PR, Grossniklaus HE. Sentinel lymph node biopsy for eyelid and conjunctival tumors: what is the evidence? Int Ophthalmol Clin. 2015;55(1):123-36.

  • 15. Lazarevic D, Ramelyte E, Dummer R, Imhof L. Radiotherapy in Periocular Cutaneous Malignancies: A Retrospective Study. Dermatol Basel Switz. 2019;235(3):234-9.

  • 16. Knackstedt T, Knackstedt RW, Couto R, Gastman B. Malignant Melanoma: Diagnostic and Management Update. Plast Reconstr Surg. 2018;142(2):202e-16e.


Journal + Issues