Malignant Melanoma of the Eyelid

Description
Melanoma of the eyelid is a relatively rare tumor making up less than 1% of eyelid cancers. It typically appears as a pigmented thickening (tumor) of the eyelid or extension of pigment from the conjunctiva.

Eyelid Melanoma - Note the melanomatous extension onto the eyelid margin. A simple wedge-biopsy confirmed the diagnosis, and was followed by complete removal with margins.

Hutchinson's Freckle - Sometimes referred to as the primary acquired melanosis (PAM) of the skin. But, due to the high risk of malignant transformation of these lesions, they are being treated more aggressively.

Symptoms
Malignant melanoma of the eyelid is distinguished from an eyelid nevus in that it can be variably pigmented, change color, bleed and/or grow. All pigmented tumors of the eyelid should be evaluated by an eye care specialist with experience with melanoma.

Diagnosis
All pigmented eyelid tumors should be photographed for comparison with future examinations. Patients should keep a copy of their baseline photographs.

Malignant melanoma of the eyelid is distinguished from an eyelid nevus in that it can be variably pigmented, change color, bleed and/or grow. Suspicious eyelid tumors should be evaluated by biopsy. A simple wedge biopsy can be sent for pathologic evaluation to aid in the diagnosis.

Treatments
If the pathologic diagnosis is malignant melanoma of the eyelid, a medical work-up is ordered to rule out metastatic spread to other parts of the body. If there is no metastatic disease, the tumor can be surgically removed (including large margins of normal appearing tissue). At the time of surgery, some doctors will also remove regional lymph nodes near the tumor (in order to determine if the tumor has locally spread).

Ophthalmic plastic surgery techniques are usually required to repair the defect caused by tumor removal. Most all patients can be repaired using one of these techniques (see Treatment Types Section).

Related Links
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