Conjunctival Melanoma in Youth: Case Report of an Asian Female
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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.
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References
Kaštelan S, Gverović-Antunica A. Conjunctival melanoma - epidemiological trends and features. Pathol Oncol Res. 2018;24(4):787-96.
Gkiala A, Damato BE. Conjunctival melanoma: Update on genetics, epigenetics and targeted molecular and immune-based therapies. Clin Ophthalmol. 2020;14:3137-52.
Ditta LC, Shildkrot Y, Wilson MW. Outcomes in 15 patients with conjunctival melanoma treated with adjuvant topical mitomycin C: Complications and recurrences. Ophthalmol. 2011;118(9):1754-9.
Wong JR, Nanji AA, Galor A, Karp CL. Management of conjunctival malignant melanoma: A review and update. Expert Rev Ophthalmol. 2014;9(3):185-204.
Albreiki DH, Gilberg SM, Farmer JP. Conjunctival malignant melanoma: A rare variant and review of important diagnostic and therapeutic considerations. Saudi J Ophthalmol. 2012;26(2):151-6.
Dalvin LA, Ancona-Lezama D, Lucio-Alvarez JA, Mashayekhi A, Shields CL, Shields JA. Conjunctival melanoma: Outcomes based on age at presentation in 629 patients at a single ocular oncology center. Cornea. 2021;40(5):554-63.
Pe’er J, Finger PT. Conjunctival melanoma. In: Pe’er J, Damato BE, Singh AD, editors. Clinical Ophthalmic Oncology. Springer; 2024. 63–81 p.
Butt K, Hussain R, Coupland SE, Krishna Y. Conjunctival melanoma: A clinical review and update. Cancers (Basel). 2024;16(18):3121.
Cohen VML, O’Day R. Management issues in conjunctival tumours: Conjunctival melanoma and primary acquired melanosis. Ophthalmol Ther. 2019;8(4):521-34.
Saleem A, Narala S, Raghavan SS. Immunohistochemistry in melanocytic lesions: Updates with a practical review for pathologists. Pathol Res Pract. 2022;239(4):239-47.
Nahon-Estève S, Basli E, Gastaud P, Gastaud L. Small but challenging conjunctival melanoma: New insights, paradigms and future perspectives. Cancers (Basel). 2021;13(22):5691.
Souza LCA, Mendes SLB. Conjunctival melanoma and role of immunohistochemical markers protein S100, HMB-45 and Melan A in tumor staging: Case report and literature review. J Surg Curr Trends Innov. 2019;3(1):1-6.
