Conjunctival melanoma with pronounced central corneal invasion: One-year relapse free follow-up

TL;DR

A rare case of conjunctival melanoma with deep corneal invasion was successfully treated and showed no relapse after one year.

Contribution

This paper reports a rare case of conjunctival melanoma with 4 mm central corneal invasion and successful treatment using mitomycin c.

Findings

A 69-year-old patient had a corneal lesion diagnosed as conjunctival melanoma with 4 mm central corneal invasion.

Surgical excision with mitomycin c and amniotic membrane transplantation resulted in no tumor relapse after 12 months.

This case highlights the rarity and successful management of pronounced central corneal involvement in conjunctival melanoma.

Abstract

Conjunctival melanoma with large corneal involvement is a rarity. We here present a case of conjunctival melanoma with pronounced central corneal involvement.

A 69-year-old fair white male presented with a visual axis impeding corneal nodular lesion with associated conjunctival melanosis. Tumor excision with intraoperative mitomycin c (0.02 %) application for 180 seconds and amniotic membrane transplantation for defect coverage was performed in retrobulbar anesthesia. Histopathological evaluation revealed the nodular lesion to be a conjunctival melanoma (pT1a) with associated conjunctival melanocytic intraepithelial lesion (C-MIL).

Most conjunctival melanomas with corneal affection reach a radial corneal involvement of 1 mm. The here reported case accounted for 4 mm, which is seldom and therefore an important report. Surgical excision followed by intraoperative and postoperative mitomycin c exposure was a successful primary treatment. Currently there are no signs of tumor relapse in any part of the eye or the organism 12 months after excision. However, the long-term follow-up needs to be awaited.

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