Skip to main content
  • Submitted by Syeda Sana Fatima, Jr, MS.
    File Size: 142 KB
    Ocular Pathology/Oncology, Oculoplastics/Orbit

    Lacrimal sac melanoma is an exceptionally rare tumor, with fewer than 100 cases reported in the literature. A 78-year-old woman presented with a 1-year history of progressive epiphora and a palpable mass in the medial canthal region. Ophthalmic examination revealed a pigmented lesion involving the lacrimal sac, suspicious for malignancy. Biopsy confirmed the diagnosis of malignant melanoma. Diagnostic Workup: Imaging studies, including CT and MRI scans, demonstrated local invasion of the lacrimal sac without evidence of distant metastasis. Histopathological examination revealed malignant melanoma. Histopathological examination also revealed highly pleomorphic tumor cells having round to oval vesicular nuclei with prominent nucleoli with few cells that showed hyperchromatic nuclei having moderate eosinophilic cytoplasm, and noted brown pigment s/o melanin in many tumor cells intracellularly and extracellularly. Focal areas of necrosis were seen along with chronic inflammatory cell infiltrate in the stromal mitosis, 0-1 mitosis. This case highlights the importance of vigilant clinical assessment and prompt biopsy. Further research is warranted to elucidate optimal treatment strategies and long-term outcomes. Multidisciplinary collaboration among ophthalmologists, oncologists, and pathologists is crucial for optimal management.