To the Editor.
—Balloon cells in cutaneous nevi and melanomas have lucent cytoplasm due to vacuolar disorganization of melanosomes.1 Although previously described in association with conjunctival nevi, balloon cell transformation has not been reported in malignant melanoma of the conjunctiva.2,3
Report of a Case.
—A 59-year-old woman was referred for evaluation of a right upper eyelid tumor that was first noticed by the patient one month earlier. On examination her corrected visual acuity was 20/20 OU. A firm mass was palpable through the skin of the right upper eyelid. It involved the entire breadth of the lid and in some areas was more than 1 cm thick. The tumor extended into the right lower eyelid and could be seen in the inferior conjunctival cul-de-sac as an ill-defined cream-colored mass (Fig 1). Biopsy specimens from the inferior conjunctival cul-de-sac were placed immediately into a buffered solution of 4% formaldehyde