Cutaneous Melanoma Metastatic to Extraocular Musculature

Abstract

Abstract: : Purpose: To present three cases of cutaneous melanoma metastatic to the extraocular musculature. Methods: Retrospective case series of three patients with a previous history of cutaneous melanoma. Results: Symptoms at presentation varied among the three cases. In one case a metastatic nodule to the lateral rectus was discovered radiographically during workup for a choroidal metastasis in the contralateral eye. A second patient presented with five months of ptosis followed by three weeks of vertical diplopia. Further evaluation revealed metastases to the superior rectus – levator complex. Case three involved a presentation of an acquired Brown’s Syndrome, secondary to melanoma metastatic to the superior oblique. In two out of the three cases, melanoma was confirmed by fine needle aspiration with immunoperoxidase staining. Conclusions: Extraocular musculature is an uncommon site for metastatic melanoma. Symptoms at presentation vary considerably. Nonoperative means of acquiring histopathologic data is possible employing fine needle aspiration with immunoperoxidase confirmation.

Keywords: melanoma • oncology • strabismus: etiology