We report a rare case of isolated mediastinal and inferior mediastinal lymph node metastases from choroidal melanoma. The patient was treated for primary choroidal melanoma with local tumour resection and radioactive plaque brachytherapy. Eleven years later, he was diagnosed with metastatic disease. Molecular analysis of the metastatic tumour demonstrated a GNAQ Q209P mutation. There was no evidence of malignant blue naevus or primary melanoma of the central nervous system on physical examination or imaging. The rare modality of clinical presentation highlights the unpredictable nature of metastatic uveal melanoma.