Abstract
Purpose :
Melanocytic ocular tumors represent a significant number of ocular benign and malignant neoplasms. They originate from eyelid skin, conjunctiva or uveal melanocytes and are further classified in benign, pre-malignant and malignant tumors.They can be misdiagnosed and this may result in an incomplete or inadequate clinical or surgical treatment. The objective of this study is to evaluate the frequency, the clinicaland histopathological characteristics of those ocular melanocytic tumors in a large ocular pathology centre.
Methods :
A retrospective study of 6828 of ocular and periocular lesions over a 12-year period (May 2006 to May 2018) was conducted at the MUHC-McGill University ocularPathology & Translational Research Laboratory. Among these lesions, 2497 (36.57%) were neoplastic processes. Using this cohort, all melanocytic ocular tumors were evaluated based on their clinical and histopathological features.
Results :
Among the 2497 tumors studied, 441 (17.66%) were melanocytic tumors. The vast majority were benign (82.31%), but malignant tumors represented an important proportion (13.83%). A predominance (62.36%) was observed in women. The age of onset was between 40 and 65 years of age (42.40%). The most common site of appearance was the eyelid (52.61%), followed by conjunctiva (25.62%), uveal tract (10.20%), caruncle (4.76%) and canthus (3.17%). The most common lesion was intradermal nevus (35.37%) followed by compound nevus (31.07%) in the eyelid and conjunctiva. Melanoma represented an important cohort (13.15%). The most common site of melanoma was the uveal tract (70.69%). There were similar proportion of cases between men and women of ocular malignant melanoma. Primary Acquired Melanosis (PAM), either without (5.44%) or with atypia (2.95%) was also observed.
Conclusions :
Ocular melanocytic lesions are important clinicopathological entities affecting ocular structures with different presentations. Nevi correspond to the vast majority of melanocytic lesions located in the conjunctiva and eyelid. PAM with atypia was found to be the most important premalignant melanocytic lesion of the conjunctiva in this cohort of patients. However, melanomas of the uveal tract represent the majority of ocular melanomas. Clinicopathological correlation is essential to correctly diagnose those important lesions leading to the appropriate clinical and surgical treatment.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.