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76 year-old with recurrent conjunctival "nevus"

Thu, 02/12/2009 - 08:39 — Artur Zembowicz M.D. Ph.D.

76 year-old woman presented with a slowly enlarging nodule on the scleral surface at limbus of the right upper quadrant of the left eye. She had a biopsy 8 years earier an was told that it was a benign nevus.

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Diagnosis: 
Conjunctival melanoma
Comment: 

This case is an example of a slowly growing small cell  or "nevoid" melanoma of the conjunctiva.

The original biopsy was not available for review.

This tumor shows a number of features which should raise concern for melanoma and which, in aggregate, are diagnostic. These include:

  • large size
  • expansile large tumor nests infiltrating the sclera
  • lack of maturation
  • monotonous cytological atypia (in contrast to rare atypical or even bizzare cells sometimes seen in benign nevi)
  • stromal mitotic activity
  • invasion of cornea

 

Items this case is linked to:
Conference: 
Ophthalmic Pathology Conference
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