Conjunctival Melanoma - A Case Report
Conjunctival melanoma is a relatively rare malignancy. It is usually a pigmented, unilateral lesion, often in the perilimbal interpalpebral bulbar conjunctiva, mostly arising from primary acquired melanosis. An 81-year-old male, otherwise healthy, presented with a 2-year history of a slowly growing protruding massive pigmented tumor of the right eye. Biomicroscopy showed a massive pigmented brown tumor protruding from 3 mm of the temporal sclera and 4/5 of the temporal cornea causing mechanical ectropion with keratinized conjunctiva of the lower eyelid. The extent of the tumor was 10 o'clock with only the limbus from 2 to 4 o'clock being tumor-free. The surface of the tumor of 10 mm in size at the base and 7 mm in height was rough, necrotic, with rich feeder vessels and spotting bleedings. Cytology of the tumor surface revealed only inflammatory cells. Melanoma cell staining was negative for both HMB 45 and BerEp4(EA). Since the tumor surface was highly necrotic, a fragment was obtained and referred for histopathology. The diagnosis was: melanoma. Enucleation with no primary orbital implant was performed as a less invasive palliative surgery. An additional 4-mm fragment of the healthy-looking marginal conjunctiva was also excised. Histopathology of the tumor indicated conjunctival melanoma.
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