title: Primary orbital melanoma in association with cellular blue nevus.
abstract: OBJECTIVE
  To describe 3 cases of primary orbital melanoma associated with either known or subsequently discovered cellular blue nevus.
  
  
  METHODS
  The clinical records and surgical specimens of 3 patients who underwent orbital exenteration for primary orbital melanoma and who had a cellular blue nevus diagnosed before or after detection of the melanoma were retrospectively reviewed.
  
  
  RESULTS
  All 3 patients presented with signs and symptoms of an orbital mass. Subsequent biopsy revealed invasive melanoma. One patient had a known history of congenital cellular blue nevus of the eyelid from which the orbital melanoma originated. The other 2 patients had no known history of cutaneous pigmentation or blue nevus. In these 2 patients, the cellular blue nevus was detected on pathologic review of the orbital exenteration specimen (1 patient) or surgical biopsy specimen (1 patient). All 3 patients underwent total body positron emission tomography/computed tomography, and in all 3 results were negative for other sites of disease involvement. In the 2 patients without a previously known nevus a total body skin check was negative for other primary melanoma lesions. All 3 patients underwent orbital exenteration followed by postoperative radiation therapy.
  
  
  CONCLUSIONS
  Thorough evaluation of biopsy specimens of "primary" orbital melanoma is warranted to ensure identification of any associated blue nevus because blue nevi are precursor lesions for orbital melanoma, and the presence of a blue nevus would support a primary orbital melanoma rather than a metastatic lesion. Patients with a known blue nevus of the periocular skin and ocular adnexa should be monitored closely for signs of malignant transformation.
authors.affiliation: Orbital Oncology & Ophthalmic Plastic Surgery Program, Department of Plastic Surgery and.
authors.forename: Tarek
authors.initials: T
authors.lastname: El-Sawy
authors.affiliation: Orbital Oncology & Ophthalmic Plastic Surgery Program, Department of Plastic Surgery and.
authors.forename: Mathieu F
authors.initials: MF
authors.lastname: Bakhoum
authors.affiliation: Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Michael
authors.initials: M
authors.lastname: Tetzlaff
authors.affiliation: Orbital Oncology & Ophthalmic Plastic Surgery Program, Department of Plastic Surgery and.
authors.forename: Qasiem J
authors.initials: QJ
authors.lastname: Nasser
authors.affiliation: Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Victor G
authors.initials: VG
authors.lastname: Prieto
authors.affiliation: Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
authors.forename: Doina
authors.initials: D
authors.lastname: Ivan
authors.affiliation: Orbital Oncology & Ophthalmic Plastic Surgery Program, Department of Plastic Surgery and.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Sniegowski
authors.affiliation: Orbital Oncology & Ophthalmic Plastic Surgery Program, Department of Plastic Surgery and.
authors.forename: Vivian T
authors.initials: VT
authors.lastname: Yin
authors.affiliation: Department of Ophthalmology, The University of Colorado School of Medicine, Denver, Colorado.
authors.forename: Caroline
authors.initials: C
authors.lastname: Pan
authors.affiliation: Department of Ophthalmology, The University of Colorado School of Medicine, Denver, Colorado.
authors.forename: Vikram
authors.initials: V
authors.lastname: Durairaj
authors.affiliation: Orbital Oncology & Ophthalmic Plastic Surgery Program, Department of Plastic Surgery and.
authors.forename: Bita
authors.initials: B
authors.lastname: Esmaeli
mesh_terms: D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D008545:Melanoma / Q000473:pathology*; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000473:pathology*; D018329:Nevus, Blue / Q000473:pathology*; D009918:Orbital Neoplasms / Q000473:pathology*