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Andreise Martins Paro, Guilherme Feltrin de Barros, Juliana Portela Passos, Julia Burnier, Elvira Abreu, Miguel N Burnier; A 10-year study of melanocytic lesions of the conjunctiva. Invest. Ophthalmol. Vis. Sci. 2019;60(9):3566.
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© ARVO (1962-2015); The Authors (2016-present)
Melanocytic lesions are the most common tumors of the conjunctiva, accounting for 53% of all conjunctival neoplasms. Pigmented lesions include nevus, complexion-associated melanosis (CAM), primary acquired melanosis (PAM), and malignant melanoma. Ocular melanocytosis represents a differential diagnosis as its scleral pigmentation can masquerade as a conjunctival melanocytic lesion. Nevus is the most common conjunctival melanocytic lesion. There are three types of benign conjunctival nevi: junctional, compound and subepithelial, according to the proliferation site within the conjunctival mucosa. The purpose of this study is to evaluate the incidence as well as the clinicopathologic features of melanocytic lesions of the conjunctiva.
A review of a 10-year period (2010 to 2018) at the MUHC-McGill University Ocular Pathology & Translational Research Laboratory was conducted. Of 4,209 lesions, 74 cases of conjunctival melanocytic lesions were found. Clinical information such as age, sex and lesion type were also recorded.
The mean age of the 74 patients was 40.3 years old (range 3 - 81 years). There was a slight gender predilection towards men (58.1%, n= 43). Of the 74 cases, 10 (13.5%) were malignant and 64 were benign (86.5%). Atypical lesions included PAM with atypia (n= 4, 40%) and atypical, dysplastic nevi (n= 4, 40%). There was no gender predominance in the atypical cohort. Forty-five nevi (70.3%) and 19 PAM without atypia (29.7%) were diagnosed. Men were slightly more affected than women in the benign cases. In cases of nevi, the mean age was 40.9 years, with the highest prevalence in the 1 to 20 year group (44.4%). The most prevalent age range of PAM without atypia was 41 to 70 years (78.9%).
The majority of melanocytic lesions are benign and an accurate diagnosis can be achieved with clinicopathological correlation. Special attention to PAM with atypia is warranted due to the high number of malignant transformation. All conjunctival melanocytic lesions should be examined histopathologically order to rule out pre-malignant or malignant transformation.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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