# Lacrimal Drainage System and Nasal Cavity Melanoma after Complete Treatment of Conjunctival Melanoma

## TL;DR

This paper reports a rare case of conjunctival melanoma spreading to the nasal cavity and lacrimal sac, highlighting a possible noncontiguous tumor spread route.

## Contribution

The paper presents a novel case of melanoma extension through the nasolacrimal duct, not previously described in detail.

## Key findings

- Melanoma recurred in the nasal cavity and lacrimal sac two years after primary surgery.
- No distant metastasis was observed, suggesting a noncontiguous spreading route.
- The case emphasizes the importance of surgical technique and follow-up for disease monitoring.

## Abstract

Malignant melanoma of the conjunctiva is a rare tumor of the ocular surface with potential fatal consequences and a high likelihood of recurrence. Although routes for extending the tumor, including local, hematogenous, and lymphatogenous, are pretty straightforward, the indirect extension through free-floating tumoral cells to the nasolacrimal duct is not described thoroughly. We report a case of malignant melanoma of the conjunctiva which presented with local recurrence in the intranasal cavity and lacrimal sac two years after the primary surgery (without involvement of the ocular surface and punctum on the second occasion). However, there was no evidence of distant metastasis on either occasion. This case demonstrates the possible noncontiguous spreading route of melanoma tumoral cells and highlights the need for attention to the surgical technique, and careful follow-up to detect further disease activity.