Sentinel lymph node biopsy in a case of conjunctival melanoma

Aims/Purpose: To present the first case of a sentinel lymph node biopsy for ocular melanoma in our hospital. Methods: We present the clinical case of a patient treated in our unit for conjunctival melanoma in the right eye. An excision of the conjunctival lesion with safety margins was performed, followed by the application of mitomycin C, cryotherapy, and placement of an amniotic membrane. The histopathological diagnosis confirmed an invasive nodular melanoma pT2aNxMx Breslow 1.5 mm with clear margins. Subsequently, three weekly cycles of 0.04% mitomycin C eye drops were administered. The extension study ruled out disease dissemination. Results: The case was presented to the Melanoma Committee, where it was decided to perform a sentinel lymph node biopsy. The procedure was carried out without evidence of metastasis in the analyzed lymph node (0/1), confirmed by histological examination with Hematoxylin‐eosin and immunohistochemistry with HMB45 and SOX10. This is the first case of a sentinel lymph node biopsy for ocular melanoma in our hospital. Thanks to close collaboration between the Ophthalmology and Radiology departments, the procedure was performed correctly. Currently, the patient continues with successive follow‐ups by Ophthalmology, showing good evolution. This case highlights the importance of interdisciplinary collaboration in the management of conjunctival melanoma and the efficacy of adjuvant treatments, such as mitomycin C, in preventing local recurrences Conclusions: Current literature supports the performance of sentinel lymph node biopsy in cases of conjunctival melanoma due to its ability to detect micrometastases and guide therapeutic management, thus improving patient prognosis. It is a valuable tool in the accurate staging of conjunctival melanoma, allowing for earlier intervention in case of lymphatic dissemination and potentially improving survival rates.