DOI: https://doi.org/10.36347/sjmcr.2025.v13i10.019

Pages: 2266-2269

Uveal melanoma is the most common primary intraocular malignancy in adults, yet it remains a rare disease compared to cutaneous melanoma. It carries a high potential for local invasion and distant metastasis, with advanced presentations sometimes leading to orbital extension, optic nerve involvement, or even globe rupture. Histologically, it is characterized by malignant melanocytic proliferation with variable pigmentation and nuclear atypia. We report the case of a 60-year-old woman with an advanced uveal melanoma of the left eye, complicated by ocular rupture and orbital invasion, treated with orbital exenteration. Beyond its unusual and severe presentation, this case provides an opportunity to discuss the role of adjuvant therapy in such scenarios. Indeed, while surgery remains the cornerstone of management in extensive disease, the possible indications for postoperative radiotherapy or systemic chemotherapy remain an open question, particularly in the presence of high-risk features. This report underlines both the aggressive behavior of delayed-diagnosed uveal melanoma and the importance of multidisciplinary discussion to clarify the potential benefit of adjuvant treatment strategies aiming to improve long-term outcomes.