A Rare Thyroid Metastasis from Uveal Melanoma andResponse to Immunotherapy Agents

hyroid metastasis is a rare occurrence with cutaneous melanoma and even more uncommon with uveal melanoma. Themanagement of such metastasis is uncertain due to its infrequency and, in the era of immunotherapy, the effect of these novel drugson uncommon metastasis, such as to the thyroid, is unknown. We report the rare case of a thyroid metastasis in a patient diagnosedwith ocular melanoma initially managed with enucleation. Metastatic disease developed in the lung and thyroid gland. The casepatient received the immunotherapy ipilimumab with stable disease in the thyroid and progressive disease elsewhere. The patientwas then further treated with a second immunotherapy agent, pembrolizumab, and remains with stable disease one year later. Wediscuss the current literature on thyroid metastases from all causes and the optimal known management strategies. Furthermore,we provide an original report on the response of this disease to the novel immunomodulators, ipilimumab, and pembrolizumabwith stable disease four years after initial diagnosis of ocular melanoma.