Primary orbital melanoma - Report of a rare case and review of literature

Abstract

Primary orbital melanoma is a rare scenario with an uninvolved globe and no intra-ocular component. A 44-year-old male had complaints of diplopia in the right eye for 3 months associated with numbness around the right eye and cheek. Superomedial eccentric proptosis was present, the pupil was reacting to light, and depression and abduction were restricted. Magnetic resonance imaging suggested was suggestive of a schwannoma with intra-orbital extension. Inferior orbitotomy with excision biopsy was performed. The biopsy sample was sent for HPE and surprisingly turned out to be melanoma, IHC HMB 45+. A dangerous diagnosis in disguise can be revealed by diligent efforts of orbital dissection.