In the case ofnasolacrimal duct epithelial infiltration noted during the surgery, removal ofpigmented lesions as deep in the nasolacrimal duct as possible would be recommended.In case of local recurrence mainly from the nasolacrimal duct lesion, furtherradical surgery would not be recommended and molecular target drugs would be bettertried in the situation of unresectable tumor after the BRAF mutation is confirmed.Lymph node metastasis and distant metastasis are, of course, the indication ofchemotherapy with molecular target drugs. Here, BRAF is linked to metastatic malignant neoplasm in the lymph nodes.