Multimodal treatment for extensive recurrent lentigo maligna melanoma

Abstract

Lentigo maligna melanoma (LMM) is a type of invasive melanoma. When LMM comprises periocular and ocular tissues, sequential multimodality treatments may be needed to avoid wide surgical excisions. We report the case of a recurrent LMM after multiple excisions elsewhere that involved the entire lower eyelid and lateral part of the upper eyelid skin, extending to the lower tarsal conjunctiva and conjunctival fornix. It was successfully controlled by a multistep approach using orthovoltage radiotherapy, topical chemotherapy, and cryotherapy, saving the patient from exenteration. The patient is still in disease-free status in the fourth year after multistep approach.