A Case of Giant Conjunctival Nevus Mimicking Malignant Melanoma

PURPOSE: We report a case of giant conjunctival nevus and compare differential diagnosis between giant conjunctival nevus and conjunctival malignant melanoma. CASE SUMMARY: A 46-year-old male presented with brown and elevated conjunctival mass in his right eye since childhood. The mass was located at the superior bulbar conjunctiva involving the superior cornea. The mass was 16 x 9 mm in size and elevated. Feeding vessels, intrinsic vessels and various cyst sizes were observed inside the mass. Resection of the conjunctival mass and amniotic membrane transplantation were performed. The histopathological diagnosis was conjunctival nevus. CONCLUSIONS: Conjunctival nevus is a benign conjunctival tumor with excellent prognosis, often confused with conjunctival melanoma. Both conjunctival nevus and conjunctival malignant melanoma are commonly located in the bulbar conjunctiva, pigmented and often have feeder and intrinsic vessels. Conjunctival nevus has an intralesional cyst, which is a key differentiating characteristic from malignant melanoma as many other features overlap. The change in tumor size, increased pigmentation and corneal invasion are features suspect of malignant transformation and surgical excision and histologic examination are recommended for those lesions. Surgical excision for giant conjunctival nevus can cause several ocular complications such as symblepharon. Conjunctival reconstruction with amniotic membrane transplantation is useful for preventing complications.

Clinical Follow-up of Conjunctival Malignant Melanoma

PURPOSE: To investigate the clinical features and course of conjunctival malignant melanoma in Korea. METHODS: The medical records of 15 patients, 5 males and 10 females, diagnosed with conjunctival malignant melanoma who had been treated at Severance Hospital from May 1991 to March 2004 were reviewed retrospectively. The clinical parameters of the patients, tumors, and treatment were analyzed for their relation to outcome measures. RESULTS: The mean age at the time of diagnosis was 53.4 years (+/-11.7 years). In all cases, the disease was unilateral and all patients had experienced at least one recurrence. Local lymph node metastasis was found in 3 patients (20%) and the mean time to metastasis was 3.5 years. Systemic metastasis was found in 6 patients (40%) and the mean time to metastasis was 9.3 years. There were 5 cases of tumor-related death (33.3%), 4 of which were attributed to systemic metastasis. The Kaplan-Meier estimates of cumulative survival rate were 90% at 30 months and 56.6% at 70 months. CONCLUSIONS: Although conjunctival malignant melanoma is a rare disease, it is life-threatening and complete tumor excision at an early stage is mandatory, as is additional therapy to prevent local recurrence and systemic metastasis.

A Conjunctival Malignant Melanoma Involving the Cornea

In a case of conjunctival malignant melanoma involving the cornea, we evaluated the findings of H,E, Fontana-Masson, S-100 protein, HMB 45 stain after the localized excision in 39 years old male patient. B-scan ultrasonography, orbit, MRI, Ga citrate scanning and bone scan showed no metastasis to the intraocular tissue, orbital adnexae and other organs. In H-E stain, spindle cells containing melanin pigment which was growing diffusely underneath the conjunctival epithelium could be seen. Fontana-Masson and S-100 protein staining resulted in diffusely positive findings, Therefore we could diagnose as 8 spindle B type malignant m.elanom.a. By histopathological examination, in a case of confirmed spindle B type COunctival malignant melanoma involving the cornea, good result, could be obtained by localized excision followed by 11 months.

A Conjunctival Malignant Melanoma in a Child

Case Report Conjunctival malignant melanoma is a rare disease. Especially it is extremely rare before thirties and after eighties. In our country, several cases of malignant melanoma in conjunctiva of adult reported, but no case in child. We have experienced a case of malignant melanoma in bulbar conjunctiva occurring in a 4-year-old boy. We reviewed the available literatures regarding this disease.