A 59-year-old woman underwent enucleation for choroidal melanoma. She had a late 
recurrence of the melanoma, which was treated with surgery and radiotherapy. 
Nine years after radiation treatment, she presented with pain and an orbital 
mass. Biopsy of the mass revealed an osteoblastic osteosarcoma. This report 
describes the late recurrence of choroidal melanoma and subsequent 
radiation-induced osteosarcoma. The risk of radiation-induced malignancy should 
be considered in all patients receiving radiotherapy. Despite yearly review, 
osteosarcoma was diagnosed only when the patient had symptoms, thus raising 
questions about the merits of long-term follow-up in detecting recurrence or 
emergence of secondary tumors.