# 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.

## Key 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.