Russo A, Patanè V, Pezzella MC, Troiani T, Argenziano G, Reginelli A. Ultra-high-frequency ultrasound in the detection of recurrent conjunctival melanoma: A case report. World J Clin Cases 2026; 14(4): 117226 [PMID: 41695762 DOI: 10.12998/wjcc.v14.i4.117226]
Corresponding Author of This Article
Vittorio Patanè, MD, Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Piazza Luigi Miraglia 2, Naples 80138, Campania, Italy. vittorio.patane@unicampania.it
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Oncology
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Case Report
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Feb 6, 2026 (publication date) through Mar 6, 2026
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World Journal of Clinical Cases
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Russo A, Patanè V, Pezzella MC, Troiani T, Argenziano G, Reginelli A. Ultra-high-frequency ultrasound in the detection of recurrent conjunctival melanoma: A case report. World J Clin Cases 2026; 14(4): 117226 [PMID: 41695762 DOI: 10.12998/wjcc.v14.i4.117226]
World J Clin Cases. Feb 6, 2026; 14(4): 117226 Published online Feb 6, 2026. doi: 10.12998/wjcc.v14.i4.117226
Ultra-high-frequency ultrasound in the detection of recurrent conjunctival melanoma: A case report
Anna Russo, Vittorio Patanè, Maria Cristina Pezzella, Teresa Troiani, Giuseppe Argenziano, Alfonso Reginelli
Anna Russo, Vittorio Patanè, Alfonso Reginelli, Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Campania, Italy
Maria Cristina Pezzella, Department fo Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Campania, Italy
Teresa Troiani, Division of Oncology, Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
Giuseppe Argenziano, Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Campania, Italy
Author contributions: Russo A, Patanè V, Argenziano G, and Reginelli A contributed to conceptualization; Russo A, Patanè V, Troiani T, Argenziano G, and Reginelli A contributed to methodology; Patanè V, Pezzella MC, and Troiani T contributed to validation; Russo A and Patanè V contributed to formal analysis; Russo A, Patanè V, Pezzella MC, and Troiani T contributed to investigation; Troiani T, Argenziano G, and Reginelli A contributed to resources; Russo A and Pezzella MC contributed to data curation; Russo A contributed to writing - original draft preparation; Patanè V, Pezzella MC, Troiani T, Argenziano G, and Reginelli A contributed to writing - review and editing; Russo A and Patanè V contributed to visualization; Troiani T, Argenziano G, and Reginelli A contributed to supervision; Troiani T, Argenziano G, and Reginelli A contributed to project administration; all authors have read and approved the final version of the manuscript.
Informed consent statement: Informed consent was obtained from the patient for the use of anonymized clinical data and images for publication purposes.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Vittorio Patanè, MD, Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Piazza Luigi Miraglia 2, Naples 80138, Campania, Italy. vittorio.patane@unicampania.it
Received: December 4, 2025 Revised: January 6, 2026 Accepted: January 19, 2026 Published online: February 6, 2026 Processing time: 65 Days and 20.5 Hours
Abstract
BACKGROUND
Conjunctival melanoma is rare and prone to local recurrence, and optimal surveillance imaging of the ocular surface and periocular skin is not standardized. We report the use of ultra-high-frequency ultrasound (UHFUS) to map multiple clinically subtle recurrent nodules in a previously treated conjunctival melanoma (Co-M) patient undergoing immunotherapy. This case supports incorporating UHFUS into multidisciplinary follow-up, showing how it can non-invasively detect occult recurrence and guide staging and treatment planning.
CASE SUMMARY
A middle-aged patient with a history of conservatively treated left Co-M was referred for suspected local recurrence, reporting a new palpable subcutaneous lump near the lateral orbital rim and a pigmented lesion at the medial canthus of the same eye. Clinical examination confirmed a periocular nodule suggestive of relapse. Cervical lymph node ultrasound showed no suspicious lymphadenopathy. UHFUS (48 MHz) with Doppler of the periocular region revealed epidermal thickening at the medial canthus and three subepidermal nodules in the lower eyelid and lateral canthus, with irregular morphology and increased vascularity, highly suggestive of recurrent melanoma and satellite lesions. The patient was already receiving first-line anti-programmed cell death 1 immunotherapy; high-frequency ultrasound findings refined local staging, confirmed absence of nodal involvement, and supported multidisciplinary planning and imaging-based follow-up.
CONCLUSION
UHFUS can non-invasively detect and map recurrent Co-M, improving local staging and guiding multidisciplinary follow-up.
Core Tip: This case report describes recurrent conjunctival melanoma in a previously treated eye, evaluated with ultra-high-frequency ultrasound (UHFUS) (48 MHz). UHFUS accurately depicted subtle periocular epidermal thickening and multiple subepidermal nodules not fully appreciated on clinical examination, while confirming the absence of suspicious cervical lymph nodes. Integrating UHFUS into multidisciplinary follow-up refined local staging in a patient on anti-programmed cell death 1 therapy and supported an imaging-based, organ-preserving management strategy.
