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Jerry A. Shields, MD; Ralph C. Eagle Jr, MD; Roberta E. Gausas, MD; Walter E. Bundy III, MD; Carol L. Shields, MD

Arch Ophthalmol. 2009;127(9):1222-1224.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Conjunctival metastasis from cutaneous melanoma typically reaches the conjunctiva by hematogenous routes.^1-7 We report a unique case of presumed retrograde conjunctival metastasis via lymphatic channels.

Report of a Case

A 61-year-old man developed cutaneous melanoma in the right preauricular skin. It was managed by surgical resections, skin grafts, irradiation, chemotherapy, and laser for local recurrences and cervical node metastasis. After 18 months, he was referred for progressive ipsilateral conjunctival pigmentation.

Examination disclosed cutaneous pigmentation and scarring in the right preauricular area (Figure 1A). The ipsilateral conjunctiva showed a peculiar widespread linear network of pigment (Figure 1B and C). The branching pattern was suggestive of lymphatic infiltration, and nearby conjunctival blood vessels were normal. Our clinical diagnosis was retrograde spread of cutaneous melanoma to conjunctival lymphatics.

Figure appears in full text version. Figure 1. Recurrent . . . [Full Text of this Article]

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