Intracorneal invasion of the ciliary body by melanoma

The authors report a case of a slow reduction of vision in the left eye of a 69-year-old woman. The slit-lamp examination of the eye showed a vascularized achromic subconjunctival mass close to the nasal limbus, invading the inferonasal corneal quadrant. At B-scan and standardized A-scan echography, the mass was shown to be localized to the ciliary body, with characteristics of a malignant melanoma. The patient did not want to undergo conservative treatment. Therefore, enucleation was performed and light microscopy revealed a pigmented malignant melanoma of the ciliary body with extrascleral growth and infiltration of the anterior third of the corneal stroma. No alteration of Bowman's membrane was present. The corneal infiltration, limited to the anterior third of the stroma, could be due to the fact that at this level the collagen fibers are disposed less regularly than those of the posterior two-thirds, with this different disposition responsible for the weak resistance opposed to the tumoral invasion.