{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T07:50:18Z","timestamp":1767599418873,"version":"3.48.0"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T00:00:00Z","timestamp":1767571200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>\n                      To report an unusual case of two distinct primary orbital melanomas emerged 9\u202fyears following evisceration for congenital corneal staphyloma and implantation of a MEDPOR\n                      <jats:sup>\u00ae<\/jats:sup>\n                      prosthesis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case description<\/jats:title>\n                    <jats:p>\n                      A 14-year-old female with congenital blindness and progressive right globe enlargement since birth, accompanied by multiple cutaneous blue nevi, initially underwent right eye evisceration with MEDPOR\n                      <jats:sup>\u00ae<\/jats:sup>\n                      implant placement in 2012, revealing congenital corneal staphyloma and proliferative vitreoretinopathy on histopathology. Nine years later, she presented with chronic right eye tearing and intermittent bloody discharge. Examination revealed a prominent scalp blue nevus with satellite lesions, mild orbital implant protrusion, conjunctival congestion, and a subconjunctival black mass. MRI identified a 1.9\u202fcm\u202fT1-slight hyperintense, T2-hypointense mass superior to the implant, with inferior rectus thickening. Surgical excision yielded two masses: a 41\u202fmm inferonasal lesion (partially pigmented, unencapsulated) and a 20\u202fmm superior\u2013posterior black, spherical mass. Histopathology confirmed orbital malignant melanoma, with tumor cells positive for S-100 (3+), Melan-A (3+), and HMB-45 (2+). NGS revealed no pathogenic variants, and PET\/CT showed no metastasis. She subsequently underwent postoperative radiotherapy and maintains good overall health until June 2025.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This article reports a case of primary orbital melanoma presenting as two tumors within a single orbit following evisceration, with a focus on elucidating the origin of tumor cells and their relationship with pigmented nevi and orbital implants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Blue nevi may represent an underrecognized risk factor for primary orbital melanoma, and enucleation may be preferable to evisceration for idiopathic corneal staphyloma to reduce melanoma risk.<\/jats:p>\n                  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