# Malignant Transformation of Reese's Melanosis: A Case of Conjunctival Melanoma and Related Therapeutic Modalities

## TL;DR

This paper discusses a case of conjunctival melanoma that developed from Reese's melanosis and explores treatment options including surgery and targeted therapies.

## Contribution

The paper presents a case of malignant transformation from Reese's melanosis and highlights the potential of BRAF inhibitors in treatment.

## Key findings

- A 56-year-old patient with recurrent Reese melanoma showed no recurrence after treatment with mitomycin C eye drops.
- BRAF mutations in conjunctival melanoma suggest potential for targeted therapies like BRAF inhibitors.
- Radiotherapy is recommended alongside surgery to reduce recurrence risk.

## Abstract

Conjunctival melanoma is a rare but aggressive condition that can arise from healthy conjunctiva, pre-existing nevi, or precancerous conditions like Reese's melanosis. This acquired primary conjunctival melanosis can significantly impact an individual's quality of life due to its potential for recurrence and metastasis. Effective treatment typically requires a multidisciplinary approach to optimize outcomes. We present the case of a 56-year-old patient with recurrent Reese melanoma who underwent multiple surgeries. During the last intervention, a malignant transformation into melanoma was discovered. Due to the absence of brachytherapy facilities, the patient received local treatment with mitomycin C eye drops. Despite this limitation, the patient showed no signs of recurrence one year post-treatment. Given the high risk of local recurrence after surgery alone, additional radiotherapy is recommended and should be systematically discussed. Regular monitoring and timely intervention are essential to prevent disease progression. Notably, the frequent BRAF (B-Raf proto-oncogene, serine/threonine kinase) mutation in conjunctival melanoma opens possibilities for targeted therapies, such as BRAF inhibitors, offering promising options for management alongside traditional surgical approaches.