Abstract
BACKGROUND: Orbital recurrence from uveal melanomas occurs in 3-23 % of enucleated eyes and poses a management challenge. Treatment options are disfiguring, and many tumors will progress despite management with surgery and radiation. CASE REPORT: This case explores the use of pembrolizumab to an orbital recurrence of uveal melanoma. A 80-year-old man developed recurrent orbital disease 11 years after enucleation for uveal melanoma and refused exenteration. As alternate management option he received 200 mg every three weeks of pembrolizumab. The orbital recurrence was reduced in size by 60 % in dimension as measured by MRI and CT imaging. After 20 months of treatment, the patient experienced deterioration of the dementia and spontaneously discontinued the therapy. CONCLUSION: This case demonstrates that pembrolizumab therapy can result in tumor regression of recurrent orbital uveal melanoma and it eventually may be helpful as a neoadjuvant treatment.