Abstract
An 88-year-old female presented with an erythematous, rapidly enlarging 5 cm mass involving her right eyelid. Biopsy revealed this to be a recurrence of her melanoma initially biopsied a year prior. The original lesion was a 1.5 cm ulcerated desmoplastic melanoma with a Breslow thickness of 7.06 mm. Final pathology was stage pT4b pN0. Wide local excision was performed with clear margins and the sentinel lymph node biopsy was negative. No evidence of metastasis was found on repeat imaging. Given the high propensity for aggressive local disease seen in pure desmoplastic melanomas and the difficult anatomic location, treatment with Talimogene laherparepvec (T-VEC) and radiation was pursued given surgical intervention would have required enucleation.
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