Clinical features and outcomes of melanoma involving eyelid and conjunctiva.

Objective: We sought to describe the long-term outcomes in patients with melanoma involving the eyelid and conjunctiva.

Design: A retrospective cohort study.

Participants: Patients with biopsy-confirmed melanoma involving the eyelid and conjunctiva.

Methods: We investigated 13 patients from a single academic center with biopsy-confirmed melanoma involving the eyelid and conjunctiva between January 2000 and December 2021. Primary endpoints included local recurrence, metastasis, and death.

Results: Presumed origin of melanoma was conjunctiva in 9 patients (69%), eyelid in 3 patients (23%), and indeterminate in 1 patient (8%). Primary treatment was exenteration in 3 patients (23%), full-thickness resection in 3 patients (23%), Mohs micrographic surgery in 4 patients (31%), and nonsurgical treatment in 3 patients (23%). Four patients (31%) underwent secondary exenteration due to tumour recurrence. Local tumour recurrence occurred in 7 patients (54%) after a mean 43 months (5-167) and metastasis in 4 patients (31%) after mean 29 months (16-46). Five patients (38%) died after a mean of 45 months (16-107) after initial melanoma diagnosis. There were 3 (23%) deaths attributable to melanoma; all had undergone exenteration during their treatment course. In the 7 (54%) patients managed with globe-sparing treatment, all had best-corrected visual acuity of 20/60 or better at last follow-up.

Conclusions: In this cohort, there was a high rate of local recurrence, metastasis, and death, regardless of whether patients received globe sparing or non-globe sparing treatment.