Conjunctival Melanoma in Youth: Case Report of an Asian Female

Abstract

Background: Conjunctival melanoma (CM) is a rare ocular malignancy, typically affecting Caucasian males over 50. Its occurrence in young Asian females is extremely uncommon, posing diagnostic and therapeutic challenges.
Case Presentation: A 34-year-old Asian female with no comorbidities presented with a progressively enlarging medial right eye mass over 2-3 years. Examination revealed a hyperpigmented, papilliform conjunctival lesion with feeder vessels from 2 to 5 o’clock, encroaching the nasal cornea. She underwent wide excision biopsy, cryotherapy, and amniotic membrane grafting. Histopathology confirmed CM, positive for Melan-A. Tumor markers were negative. She received three cycles of topical mitomycin C (MMC) 0.02%. At latest follow-up, there was no recurrence.
Discussion: This case illustrates an unusual presentation of CM in a young Asian female. Early diagnosis and prompt surgical and adjuvant management are vital in preventing recurrence. Clinicians should maintain suspicion for CM even in low-risk demographics.
Key Messages: CM is rare in young Asian females, often leading to delayed diagnosis. This case highlights the importance of early clinical suspicion, prompt surgical management, and adjuvant therapy to prevent recurrence and improve outcomes in atypical presentations of this aggressive ocular malignancy.