A 62-year-old Caucasian woman with a history of a conjunctival freckle of her left eye from the time she was 8 years old presented to us 10 days after she noticed an acute change in its size and color. She stated that a blood vessel had burst under it. She had no known history of cancer and reported no excessive sun exposure over the years. She underwent excisional biopsy with adjunctive cryotherapy.
Histopathology showed a malignant melanoma adjacent to a cystic, compound melanocytic nevus. All margins were free of tumor. An initial metastatic workup was negative and the patient has undergone screening at regular intervals. One skin biopsy performed for a melanocytic lesion of her ear was negative. She had Mohs’ surgery for a dermatofibrosarcoma protuberans, on her back, which was discovered on a skin screening prompted by her conjunctival melanoma diagnosis. ___________________________
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