Conjunctival Malignant Melanoma
Report of a Rare Case
Keywords:
Malignant Melanoma, Conjunctiva, Amelanotic, Histopathology diagnosis
Abstract
ABSTRACT Ocular melanomas comprise 3.7 percent of all melanomas. Amongst ocular structures, melanoma of conjunctiva is an uncommon tumor and comprise around 5 percent of the melanomas in the ocular region. Non-bulbar conjunctival malignant melanomas (CMM) are rare and are associated with substantial morbidity and mortality. As the presentation varies, clinical diagnosis is missed in the early stages. When CMM are amelanotic, differentiating them from other epithelial lesions on the basis of morphological features becomes even more difficult. High index of suspicion on the part of histopathologist can achieve early diagnosis of CMM on the basis of characteristic biopsy findings. Confirmed diagnosis on the basis of histopathological examination (HPE) and immunohistochemistry (IHC) studies can lead to appropriate timely management in these cases.References
1. McLaughlin CC, Wu XC, Jemal A, Martin HJ, Roche LM, Chen VW. Incidence of noncutaneous melanomas in the U. S. Cancer. 2005; 103: 1000–7.
2. Lommatzsch P K, Lommatzsch R E, Kirsch I, Fuhrmann P. Therapeutic outcome of patients suffering from malignant melanomas of the conjunctiva. British Journal of Ophthalmology. 1990; 74: 615-619.
3. Shields CL, Markowitz JS, Belinsky I, Schwartzstein H, George NS, Lally SE, et al. Conjunctival Melanoma: Outcomes Based on Tumor Origin in 382 Consecutive Cases. Ophthalmology. 2011; 118(2): 389–395.
4. Wong J R, Nanji A A, Galor A, Karp C L. Management of conjunctival malignant melanoma: a review and Update. Expert Rev Ophthalmol. 2014 Jun; 9(3): 185–204.
5. Brownstein S. Malignant Melanoma of the Conjunctiva. Cancer Control. September/October 2004; Vol. 11, No. 5: 310-316.
6. Misra S, Misra N, Gogri P, Reddy V, and Bhandari A. A case of conjunctival malignant melanoma with local recurrence. Australas Med J. 2013; 6(6): 344–347.
7. Pernick N. TNM staging (pathologic) for melanoma of the conjunctiva. PathologyOutlines.com
website. http://www.pathologyoutlines.com/topic/eyeconjTNMmelanoma.html.
8. Chang AE, Karnell LH, Menck HR. The National Cancer Data Base report on cutaneous and noncutaneous melanoma: a summary of 84,836 cases from the past decade. The American College of Surgeons Commission on Cancer and the American Cancer Society. Cancer. 1998; 83(8): 1664–1678.
9. Shields C L, Shields J A, Gunduz K, Cater J, Mercado G V, Gross N, Lally B. Conjunctival Melanoma Risk Factors for Recurrence, Exenteration, Metastasis, and Death in 150 Consecutive Patients. Arch Ophthalmol. 2000; 118: 1497-1507.
10. Jovanovic P, Mihajlovic M, Djordjevic-Jocic J, Vlajkovic S, Cekic S, Stefanovic V. Ocular melanoma: an overview of the current status. Int J Clin Exp Pathol. 2013; 6(7): 1230–1244.
11. Brownstein S, Faraji H, Jackson W B, et al. Conjunctival Melanoma in Children: A Clinicopathologic Study of 2 Cases. Arch Ophthalmol. 2006; 124(8): 1190-1193.
12. Keraliya AR, Krajewski KM, Braschi-Amirfarzan M, Tirumani S H, Shinagare A B, Jagannathan JP, et al. Extracutaneous melanomas: a primer for the radiologist. Insights Imaging. 2015 Dec; 6: 707–717.
13. Billings SD. Tumors and Tumor like conditions of skin. In: Goldblum JR, Lamps LW, McKenney JK, Myers JL. Rosai and Ackerman’s Surgical Pathology. Eleventh edition. Philadelphia: Elsevier; 2018: 77-82.
14. Salcedo-Hernández RA, Luna-Ortiz K, Lino-Silva LS, Herrera-Gómez A, Villavicencio-Valencia V, Tejeda-Rojas M, et al. Conjunctival melanoma: survival analysis in twenty-two Mexican patients. Arq Bras Oftalmol. 2014 May-Jun; 77(3): 155-8.
2. Lommatzsch P K, Lommatzsch R E, Kirsch I, Fuhrmann P. Therapeutic outcome of patients suffering from malignant melanomas of the conjunctiva. British Journal of Ophthalmology. 1990; 74: 615-619.
3. Shields CL, Markowitz JS, Belinsky I, Schwartzstein H, George NS, Lally SE, et al. Conjunctival Melanoma: Outcomes Based on Tumor Origin in 382 Consecutive Cases. Ophthalmology. 2011; 118(2): 389–395.
4. Wong J R, Nanji A A, Galor A, Karp C L. Management of conjunctival malignant melanoma: a review and Update. Expert Rev Ophthalmol. 2014 Jun; 9(3): 185–204.
5. Brownstein S. Malignant Melanoma of the Conjunctiva. Cancer Control. September/October 2004; Vol. 11, No. 5: 310-316.
6. Misra S, Misra N, Gogri P, Reddy V, and Bhandari A. A case of conjunctival malignant melanoma with local recurrence. Australas Med J. 2013; 6(6): 344–347.
7. Pernick N. TNM staging (pathologic) for melanoma of the conjunctiva. PathologyOutlines.com
website. http://www.pathologyoutlines.com/topic/eyeconjTNMmelanoma.html.
8. Chang AE, Karnell LH, Menck HR. The National Cancer Data Base report on cutaneous and noncutaneous melanoma: a summary of 84,836 cases from the past decade. The American College of Surgeons Commission on Cancer and the American Cancer Society. Cancer. 1998; 83(8): 1664–1678.
9. Shields C L, Shields J A, Gunduz K, Cater J, Mercado G V, Gross N, Lally B. Conjunctival Melanoma Risk Factors for Recurrence, Exenteration, Metastasis, and Death in 150 Consecutive Patients. Arch Ophthalmol. 2000; 118: 1497-1507.
10. Jovanovic P, Mihajlovic M, Djordjevic-Jocic J, Vlajkovic S, Cekic S, Stefanovic V. Ocular melanoma: an overview of the current status. Int J Clin Exp Pathol. 2013; 6(7): 1230–1244.
11. Brownstein S, Faraji H, Jackson W B, et al. Conjunctival Melanoma in Children: A Clinicopathologic Study of 2 Cases. Arch Ophthalmol. 2006; 124(8): 1190-1193.
12. Keraliya AR, Krajewski KM, Braschi-Amirfarzan M, Tirumani S H, Shinagare A B, Jagannathan JP, et al. Extracutaneous melanomas: a primer for the radiologist. Insights Imaging. 2015 Dec; 6: 707–717.
13. Billings SD. Tumors and Tumor like conditions of skin. In: Goldblum JR, Lamps LW, McKenney JK, Myers JL. Rosai and Ackerman’s Surgical Pathology. Eleventh edition. Philadelphia: Elsevier; 2018: 77-82.
14. Salcedo-Hernández RA, Luna-Ortiz K, Lino-Silva LS, Herrera-Gómez A, Villavicencio-Valencia V, Tejeda-Rojas M, et al. Conjunctival melanoma: survival analysis in twenty-two Mexican patients. Arq Bras Oftalmol. 2014 May-Jun; 77(3): 155-8.
Published
2018-10-27
Issue
Section
Case Report
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).
