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      Conjunctival melanoma in a child: A clinicopathological report

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          Abstract

          We report a case of a 16 years old Asian Indian boy who presented with a large brownish lesion measuring 20 × 12 mm on the temporal conjunctive in his right eye. Anterior segment optical coherence topography revealed cystic spaces without scleral involvement. The patient underwent conjunctival excisional biopsy using “no touch” technique with double freeze-thaw cryotherapy to underside of the adjacent conjunctival margins. Excision involved 4 mm of the surrounding apparently normal conjunctiva. Absolute alcohol epitheliectomy was done at the limbus and surrounding 2 mm of cornea to devitalize residual atypical melanocytes if any. Histopathology confirmed diagnosis of conjunctival melanoma. We started the patient on topical mitomycin C 0.04% with one weekly on and off cycles postoperatively. No recurrence was noted after nine months follow up.

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          Clinical survey of 1643 melanocytic and nonmelanocytic conjunctival tumors.

          Emily J. Shields, E Likaki-Karatza, Carol L. Shields … (2004)
          To report the spectrum and frequency of melanocytic and nonmelanocytic conjunctival tumors in an ocular oncology practice. Retrospective noninterventional case series. One thousand six hundred forty-three consecutive patients with a conjunctival mass evaluated at an ocular oncology department. A chart review was conducted to obtain the clinical features of the patient and tumor and to tabulate and categorize the diagnoses. Tumor diagnosis overall and relative to patient age, race, and gender and relative to tumor location and laterality. In 1643 consecutive patients, the tumor was classified as melanocytic in 872 cases (53%) and nonmelanocytic in 771 cases (47%). The nonmelanocytic categories included congenital choristomatous (n = 40 [2%]), epithelial (n = 219 [13%]), vascular (n = 63 [4%]), fibrous (n = 7 [ 60. Of the 219 patients with epithelial tumors, 80% occurred in males, whereas the incidence of melanocytic lesions was equal in males and females. African-American patients represented only 7% of epithelial tumors, <1% of melanomas, and 8% of lymphoid tumors. Conjunctival tumors were of melanocytic origin in 53% of cases and nonmelanocytic origin in 47%. Overall, melanocytic tumors, epithelial tumors, and lymphoid tumors accounted for 74% of all cases. These tumors were far more common in Caucasian patients, and epithelial tumors were found more frequently in men.
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            Conjunctival melanocytic lesions in children.

            J McDonnell, J. Carpenter, P. Jacobs … (1989)
            Seventy-one conjunctival melanocytic proliferations in patients 20 years of age or younger were examined. Sixty-five (91.5%) were nevi; there were three cases (4.2%) of racial or acquired melanosis, and three patients were identified who had malignant melanoma of the conjunctiva. The melanoma patients are presented in detail, and additional cases of conjunctival melanoma in children and adolescents reported in the literature are reviewed to determine factors that might influence prognosis. The number of cases is so small, however, that factors cannot be identified with confidence. Follow-up data are presented. Conjunctival nevi are relatively common in children, and appear to carry no risk for the development of melanoma during childhood. However, -conjunctival melanomas do occur rarely in children and have a variable prognosis.
            Article 0 comments Cited 10 times – based on 0 reviews     Review now
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              Conjunctival nevi: clinical and histopathologic features in a Saudi population

              Hind M Alkatan, Khalid Al-Arfaj, Azza Maktabi (2010)
              BACKGROUND AND OBJECTIVE: Conjunctival nevi are benign lesions with wide variation in clinical and histopathological features. The differentiation between benign nevi and other pigmented lesions is essential. The aim of our study was to identify the distribution of the histopathologic types of conjunctival nevi among the Saudi population and to provide the basic knowledge needed for proper clinical diagnosis. PATIENTS AND METHODS: This retrospective study of surgically excised benign conjunctival nevi was conducted at a tertiary care eye hospital from 1995 to 2006. Clinical data was collected from medical records and the histopathologic features reviewed by a single pathologist. RESULTS: A total 105 conjunctival nevi were included from 104 consecutive patients (mean age, 26 years, 54 males and 50 females). The anatomical location was the bulbar conjunctiva in 83%, juxtalimbal in 12%, caruncle in 4% and palpebral in 1%. The lesion was removed for cosmetic reasons in 38% while 8% of the lesions were removed to rule out malignancy. The compound nevus was the commonest (72%) in all age groups, followed by subepithelial nevus (24%) and finally junctional nevus (3%). CONCLUSIONS: The distribution of the histopathologic types of this tumor in our population matches the pattern in other areas of the world with the compound nevus being the commonest lesion. However, fewer lesions among our patients are removed to rule out malignancy.
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                Author and article information

                Contributors
                Jagat Ram
                Journal
                Journal ID (nlm-ta): Saudi J Ophthalmol
                Journal ID (iso-abbrev): Saudi J Ophthalmol
                Title: Saudi Journal of Ophthalmology
                Publisher: Elsevier
                ISSN (Print): 1319-4534
                Publication date PMC-release: 28 September 2017
                Publication date (Print): Apr-Jun 2018
                Publication date (Electronic): 28 September 2017
                Volume: 32
                Issue: 2
                Pages: 156-159
                Affiliations
                Department of Ophthalmology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
                Author notes
                [* ]Corresponding author at: Advanced Eye Center, Sector 12, Post Graduate Institute of Medical Education and Research, Chandigarh, India. drjagatram@ 123456gmail.com
                Article
                Publisher ID: S1319-4534(17)30116-9
                DOI: 10.1016/j.sjopt.2017.09.006
                PMC ID: 6010591
                PubMed ID: 29942187
                SO-VID: 62b6c9a9-7837-46d5-a935-a6beffecd10a
                Copyright © © 2017 The Authors
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 25 May 2016
                Date revision received : 3 August 2017
                Date accepted : 19 September 2017
                Categories
                Subject: Case Report

                Keywords: conjunctival melanoma,asian child,anterior segment optical coherence topography,melanoma histopathology
                Data availability:
                Keywords: conjunctival melanoma, asian child, anterior segment optical coherence topography, melanoma histopathology

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