Hepatic metastasis and orbital recurrence of uveal melanoma after 42 years.

A 70-year-old woman who had undergone enucleation of the left eye at the age of 28 years because of complications from an injury to the globe, and in whom a previously unsuspected posterior uveal melanoma was detected after enucleation, had no further problems until 42 years later, when she was discovered to have a liver malignancy of undetermined origin. After six months of chemotherapy, the patient developed a mass in the anophthalmic left orbit. Biopsy of the orbital mass disclosed malignant melanoma, and reexamination of the liver biopsy specimen disclosed similar malignant melanoma cells. The patient had no clinical evidence of a primary melanoma other than the one involving the eye. It is possible that the patient had subclinical melanoma cells in the liver for 40 years. However, another possibility is that the patient had residual melanoma cells in the orbit which eventually metastasized to the liver.