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Guilherme Feltrin de Barros, MARCELA BARROS, David Cordeiro Sousa, luca Bongiovanni, Gabriela Naomi, Miguel N Burnier; Clinicopathological analysis of juvenile patients with melanocytic lesions of the conjunctiva. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2420.
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© ARVO (1962-2015); The Authors (2016-present)
Conjunctival nevus is the most common conjunctival tumor in children, but fewer than 1% evolve into malign lesions. The purpose of this study is to evaluate agreement between clinical and pathological diagnoses of different types of melanocytic lesions in pediatric patients and to describe the most common demographic features, including gender, age and location.
We retrieved all cases of melanocytic proliferation of the conjunctive in patients <20 years of age from the Henry C. Witelson Ocular Pathology database during a 10-year period (2006 to 2015). Overall, 44 patients were included in this study. Clinical information, such as age, gender, location, type, frequency, size, and agreement between clinical and pathological diagnosis were recorded.
The mean age of the 44 patients was 11.3 years old; only 9.1% (n=4) were older than 18. There was a slightly gender predilection toward males (52.3%; n=23). There was agreement between clinical and pathological diagnosis in 77.2% of cases (n=34), and less than a quarter of patients showed atypia (22.72%; n=10) upon histopathological exam. The most common pathological diagnosis was compound nevi with different characteristics, such as congenital features, different degrees of pigmentation and presence of epithelial cysts. The atypical lesions included conjunctival melanoma (n=1), junctional nevi with atypia (n=2), compound nevi with atypia (n=5), and cystic compound nevi (n=2). Moreover, 70% (n=7) of patients with atypical lesions were male, 60% (n=6) of the specimens were from the right eye, and the mean age of this patient cohort was 10.2 years old.
Despite rarely transforming into malignant lesions, up to a quarter of conjunctival lesions in our study showed atypical features on histopathological exam. Herein, we conclude that males are more likely to develop atypical lesions.Therefore, we encourage all melanocytic lesions to be sent to histopathological analysis in order to rule out malignant disease.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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