Halas Jr M, Svetlosakova Z, Babal P
Department of Ophthalmology, Comenius University, Bratislava, Slovakia.
Bratisl Lek Listy. 2013;114(8):446-50. doi: 10.4149/bll_2013_093.
Clinical experience of our single center in dealing with pigmented epibulbar lesions - melanocytic conjunctival tumors is presented. Since 2008 we use the topical treatment with mitomycin C (MMC) as an alternative or adjunctive method for excision in the treatment of melanocytic neoplasia of the conjunctiva.
The retrospective case series of 85 patients with pigmented lesions of the conjunctiva - melanocytic conjunctival tumors, histopathologically examined in the period 2001-2010 is presented. Since 2008 we started to apply MMC in the treatment of primary acquired melanosis (PAM) and dysplastic nevi. We apply MMC topically directly after an excision as 2-times five minutes application.
In 85 patients with pigmented lesions of the conjunctiva histopathological findings after excision of the lesion showed in 68 (80 %) cases melanocytic nevocelullar nevus, out of which 55 cases were combined and 13 cases were junctional nevi. In 60 (80 %) cases of melanocytic nevi atypia was found in 25 patients (42 %), nevus without atypia was present in 35 cases (58 %). PAM with atypia was found in 16 patients (classified since 2000). During the period of application of MMC we diagnosed only one patient with primary conjunctival melanoma. There was no presence of relapse of the pigmented lesion either after primary excision or after excision with MMC.
Resection of more than one quadrant of bulbar conjunctiva in patients with pigmented lesions of the conjunctiva in cases of conjunctival nevus with atypia and PAM with atypia combined with topical MMC chemotherapy is an alternative therapy for residual pigmented lesions. There was no presence of relapse of pigmentation in area of excision with or without using MMC during the surgery in patients with PAM. The number of our patients is not sufficient yet to draw a conclusion (Fig. 6, Ref. 21).
介绍了我们单中心处理眼球表面色素沉着病变——结膜黑素细胞肿瘤的临床经验。自2008年以来，我们使用丝裂霉素C（MMC）局部治疗作为结膜黑素细胞肿瘤切除的替代或辅助方法。
呈现了2001年至2010年期间对85例结膜色素沉着病变——结膜黑素细胞肿瘤患者进行组织病理学检查的回顾性病例系列。自2008年起，我们开始将MMC应用于原发性获得性黑素沉着（PAM）和发育异常痣的治疗。我们在切除后立即局部应用MMC，每次5分钟，共应用2次。
85例结膜色素沉着病变患者病变切除后的组织病理学检查显示，68例（80%）为黑素细胞性痣细胞痣，其中55例为复合痣，13例为交界痣。在60例（80%）黑素细胞痣中，25例（42%）发现有非典型性，35例（58%）为无非典型性的痣。16例患者（自2000年起分类）发现有非典型性的PAM。在应用MMC期间，我们仅诊断出1例原发性结膜黑色素瘤患者。色素沉着病变无论是在初次切除后还是在MMC切除后均无复发。
对于伴有非典型性的结膜痣和伴有非典型性的PAM患者，在结膜色素沉着病变切除超过一个象限结膜的情况下，联合局部MMC化疗是残留色素沉着病变的一种替代治疗方法。PAM患者在手术中无论是否使用MMC，切除区域均无色素沉着复发。我们的患者数量尚不足以得出结论（图6，参考文献21）。
