Eyelid Melanoma Case Study

Eyelid Melanoma

I once evaluated a 65-year-old African American female that presented with a painless, non-pruritic left eyelid nodule. She admitted growth and discomfort for 2 years. The physical examination of the lesion revealed a 5.5x 2.5 mm, asymmetric, left lower eyelid nodule, exhibiting variegated colors (black, blue, and red), and irregular borders. The lesion originated at the inferior eyelid margin. Furthermore, the nodule had an erythematous base, however, it did not present any scaling, ulceration, or regional lymphadenopathy. Subsequently, the patient was referred to a dermatologist and ophthalmologist for further evaluation. A biopsy was performed and revealed an early stage nodular melanoma. The lesion was excised (a surgical excision with wide margins was performed). The patient was scheduled for periodic follow-up visits every 6 months. The surgical wound healed without any complications and after 3 years of monitoring there were no signs of recurrence.

According to Chaney et al. (2016), cutaneous eyelid melanoma accounts for less than 1% of eyelid malignancies and an estimated 1% of all cutaneous melanomas. Cutaneous eyelid melanomas develop from atopic proliferation of melanocytes and commonly affect the lower eyelid (Harish et al., 2013). This malignancy usually occurs in female patients older than 50. The diagnosis of cutaneous eyelid melanoma is confirmed histologically. The management of this medical condition is based on biopsy results and staging. For example, the mainstay treatment of early stage malignant melanoma of the eyelid is surgical excision (Chan, O’Donnell, Whitehead, Ryman, & Sullivan, 2007). On the other hand, Mohs micrographic surgery, is the treatment of choice for melanoma