title: Malignant transformation of kissing nevus- a rare entity.
abstract: BACKGROUND
  Kissing nevus is a congenital nevus in adjacent parts of the eyelids. Malignant transformation of kissing or divided nevi of the eyelids is rarely described.
  
  
  OBJECTIVE
  To report a very rare case of malignant transformation of kissing nevus with ocular and extraocular spread.
  
  
  METHODS
  A 57- year- old man with 6/6 visual acuity in both eyes presented with a kissing nevus present since birth in right upper and lower eyelids which had a slow growth phase. The upper lid in the area of the nevus was thickened with a 20x12x15 mm black pigmented crusted hemorrhagic nodular lesions. The lower lid had a 6 mm black pigmented ulcerated lesion over the pre-existing nevus in the lateral third of the lid with full thickness infiltration. Another 5x4 mm pigmented lesion over the lower medial lid margin with a thickness of about 3 mm extended to the conjunctival side of the lower lid. Right sided pre-auricular and sub-maxillary nodes were palpable. A biopsy of tissue samples from the eyelid and pre-auricular nodes were consistent with malignant melanoma.
  
  
  CONCLUSIONS
  Malignant transformation of kissing nevus is rare. It can spread to the conjunctiva,pre-auricular and sub-mandibular lymphnodes.
authors.affiliation: Department of Ophthalmology, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal. helloranju50@yahoo.com
authors.forename: R
authors.initials: R
authors.lastname: Kharel Sitaula
authors.forename: S
authors.initials: S
authors.lastname: Batta
authors.forename: G B
authors.initials: GB
authors.lastname: Shrestha
authors.forename: J K
authors.initials: JK
authors.lastname: Shrestha
mesh_terms: D001706:Biopsy; D002471:Cell Transformation, Neoplastic / Q000473:pathology*; D003228:Conjunctiva / Q000473:pathology*; D003230:Conjunctival Neoplasms / Q000473:pathology*; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology*; D008875:Middle Aged; D018332:Nevus, Epithelioid and Spindle Cell / Q000151:congenital / Q000473:pathology*