Conjunctival melanoma with corneal invasion
First Author: A.Cunha PORTUGAL
Co Author(s): T. Dinah Bragança R. Moreira F. Falcão-Reis
To describe a rare case of a recurrent melanoma of the conjunctiva with corneal invasion, in a female patient.
Department of Ophthalmology, Centro Hospitalar de São João Hospital, Porto, Portugal
Clinical and imaging description of a clinical case.
Female patient, 47 years old, presented to the emergency department due to sudden growth with a week of evolution of conjunctival nevus that she reported having had in the right eye for several years. No major precedents. Visual acuity was 8/10, intraocular pressure of 13 mmHg and biomicroscopy identified an exophytic temporal conjunctival melanotic tumor, with conjunctival nutritive vessels. Fundoscopically and in mode B ultrasound, without changes. Surgical excision of the lesion was performed, with histological result of conjunctival melanoma. The systemic study did not reveal the presence of metastasis. After 2 years, the appearance of a non-pigmented lesion in the conjunctiva is identified, affecting the cornea. Penetrating eccentric transplant involving cornea and sclera was performed. Histologically, corneal recurrence of melanoma was identified.
Surgical excision combined with reconstruction with penetrating corneal transplantation may be a treatment for conjunctival malignant lesions with corneal invasion. Although rare, conjunctival malignant melanoma is extremely aggressive with high rates of metastasis and mortality, so a multidisciplinary approach should be performed from patients.