Abstract
Purpose: :
Malignant melanomas of the conjunctiva represent a rare malignancy with an incidence of 0.2-0.8% in Western Europe. The high incidence of disease recurrence gives questions about the optimal adjuvant therapy.
Methods: :
Retrospective study of 57 treated patients with histologically proved conjunctival melanomas in the period from 1992 to 2008. Mean age of the patients was 61 years (28-86 years). There were 30 men and 27 women. Mean follow up period was 83 months. All patients underwent excisional biopsy for further histological determination. In 15 cases the etiology was a melanosis, in 17 cases a nevus and in 25 patients was observed a de novo melanoma. Therapy included local excision (n=57), cryocoagulation (n=13), application of mitomycin C (n=14), brachytherapy with strontium or ruthenium plaques (n=30), proton beam irradiation (n=4), roentgen beam irradiation (n=12), enucleation (n=3) and exenteration (n=8).
Results: :
56% of patients (n=32) showed no sign of recurrence during the follow-up period, whereas in 21 % (n=12) a local recurrence was detected. In 22 % (n=13) a local recurrence or a new tumor with a different localisation occured. There were 17% (n=10) of patients with metastatic manifestations.
Conclusions: :
Adjuvant therapy is necessary to complete the initially performed excisional surgery in combination with cryocoagulation to minimize the risk of recurrence.
Keywords: conjunctiva • melanoma