Case Study: August 2010


This is an exenteration specimen from a 73 year old woman. She had the initial lesion biopsied 2 years previously, but at that time declined treatment.


1. What does Figure 1 show?

2. What does Figure 2 show?

3. What does Figure 3 show?

4. What is the diagnosis?

5. What is unusual about this case?

Click to show answers
  1. There is a heavily pigmented tumour within the ciliary body and extraocular tissue.
  2. Perineural tumour permeation.
  3. Conjunctival melanosis with in-situ melanoma.
  4. Malignant melanoma.
  5. Given the presence of conjunctival melanosis with atypia, the favoured diagnosis is of primary conjunctival melanoma spreading to the ciliary body. Extraocular spread of a uveal melanoma is much more common than an extraocular melanoma extending into the eye.


Sandinha, T., Russell, H., Kemp, E. & Roberts, F. Malignant melanoma of the conjunctiva with intraocular extension: a clinicopathological study of three cases. Graefe’s Archive for Clinical and Experimental Ophthalmology 245, 431-436 (2007).

Wenkel, H., Rummelt, V. & Naumann, G.O.H. Malignant Melanoma of the Conjunctiva With Intraocular Extension. Arch Ophthalmol 118, 557-560 (2000).