Abstract
BackgroundMelanomas are malignant neoplasm of melanocytic origin, commonly seen on skin and various mucous membranes. Melanomas are the commonest intraocular malignant tumour in the adults.Case presentationA 50-year-old female presented with complains of painless progressive swelling in right cheek region of two months duration. Examination revealed a 6 × 4 cm bony hard swelling in right zygomatic region near and below lateral canthus of right eye with loss of vision. Investigations revealed it to be a choroidal melanoma metastatising to the zygomatic bone. Patient was successfully treated by surgery.ConclusionChoroidal melanoma, which commonly metastasizes to liver and lungs, never involves the lymph nodes and metastasis to facial bones is rare. Here we report a case of choroidal melanoma metastasizing to maxillofacial bones.
Highlights
Melanomas are malignant neoplasm of melanocytic origin, commonly seen on skin and various mucous membranes
Choroidal melanoma, which commonly metastasizes to liver and lungs, never involves the lymph nodes and metastasis to facial bones is rare
We report a case of choroidal melanoma metastasizing to maxillofacial bones
Summary
Choroidal melanoma is the most common primary intraocular malignant tumour [1]. They arise from uveal melanocytes residing in the uveal stroma and originating from the neural crest [2]. Examination revealed a 6 × 4 cm bony hard swelling in right zygomatic region near and below lateral canthus of right eye (Figure 1) Roentgenogram of the paranasal sinuses showed a lesion arising from right maxilla and right zygoma. A fine needle aspiration was carried out that showed typical polygonal and spindle cells with moderate amount of cytoplasm and vesicular nuclei with nucleoli, many with intracellular pigment; seen singly and clusters, the picture was suggestive of malignant melanoma (Figure 3). With a provisional diagnosis of melanoma of the maxilla and zygoma with vitreous haemorrhage and no useful vision in right eye a wide excision of the lesion including anterolateral maxillectomy, zygomectomy, and removal of superolateral wall and floor of orbit with en bloc exenteration of the right eyeball was carried out (Figure 5). CmFioagxmuilrplaeut2ed tomographic scan showing two separate lesions one in right orbit and other in right zygoma, zygomatic process of Computed tomographic scan showing two separate lesions one in right orbit and other in right zygoma, zygomatic process of maxilla
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