Open AccessMelanorrhea: Noncontiguous spread of palpebral conjunctival melanoma to the nasolacrimal duct
Author(s) -
Raksha Rao,
Santosh G Honavar,
Michelle De Padua,
Kaustubh Mulay,
Vijayanand Reddy
Publication year - 2018
Publication title -
indian journal of ophthalmology/indian journal of ophthalmology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.542
H-Index - 51
eISSN - 1998-3689
pISSN - 0301-4738
DOI - 10.4103/ijo.ijo_886_17
Subject(s) - medicine , eyelid , conjunctiva , palpebral fissure , nasolacrimal duct , histopathology , lacrimal sac , melanoma , nasolacrimal duct obstruction , surgery , ophthalmology , pathology , cancer research
A 42-year-old Asian Indian male with a history of conjunctival melanoma in the left eye presented with a recurrent tumor in the upper tarsal conjunctiva. The tumor was completely excised under margin control, followed by two-staged eyelid reconstruction. During the second stage of the eyelid reconstruction, a brown-colored discharge was noted at the punctum, which on cytology was confirmatory of melanoma. Left dacryocystectomy with en bloc nasolacrimal duct (NLD) excision was performed. Histopathology demonstrated infiltration of the NLD by the tumor with no presence of melanoma in the lacrimal sac. Lacrimal oncorrhea is a term used to describe tumor spread by free-floating cells in the tear film. All conjunctival tumors carry a risk of tumor spread by oncorrhea.