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C.H. Pastore, Sr., D.E. Pelayes, D.N. Colombero, J. Zarate; Primary Corneal Melanoma . Invest. Ophthalmol. Vis. Sci. 2006;47(13):4700.
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to present a unique case of isolated corneal melanoma without limbal or conjunctival involvement, its clinicopathological correlation and immunohistochemical analysis.
a 57–year–old man presented with an elevated sessile nodule over the central cornea of the right eye. The tumor was surrounded by clear cornea, without any connection with the limbus. No intraocular invasion was seen by ultrasound biomicroscopy, B–scan and computed tomography.
a total lamellar conjunctivo–esclero–keratectomy, cryotherapy and amniotic membrane transplantation were done. The sample was studied with hematoxylin & eosin, cytokeratins, S–100, vimentin, HMB–45 and Melan A. A neoplastic malignant proliferation of a melanocytic type was seen intraepithelially; Bowman membrane was intact. Nests of fusocellular and epithelioid cells were detected, with regular amount of pigment and mitosis, and focal epithelial compromise with acanthotic masses. The conjunctiva, limbus and peripheral cornea were free of neoplastic invasion. No primary acquired melanosis was detected. Immunohistochemistry was positive for vimentin, protein S–100, HMB–45 and Melan A, and negative for cytokeratins.
On the basis of our review of the literature, this may be the only report of a melanoma primary confined to the cornea, without any sign of displacement from conjunctiva, and its immunohistochemical confirmation.
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