Ciuntu Roxana Elena, Martinescu Gabriel, Anton Nicoleta, Danciu Mihai
Discipline of Ophthalmology, Department of Surgery II, "Grigore T. Popa" University of Medicine and Pharmacy, Iasi, Romania;
Rom J Morphol Embryol. 2018;59(1):317-322.
Conjunctival melanocytic lesions are very diverse pigmented tumors that include benign, premalignant and malignant tumors. The aim of this article is to highlight the clinical and histopathological aspects of conjunctival melanocytic tumors at children. This study is a retrospective case series study of three patients selected from fifteen cases with melanocytic conjunctival tumors who were operated in the Department of Ophthalmology, "St. Spiridon" Emergency Hospital, Iasi, Romania. A systematic review of the literature was undertaken, using an electronic search of PubMed/MEDLINE, Google Scholar and ISI Web of Knowledge, to identify original English or French articles and reviews on this subject. Patients were diagnosed by the same doctor between 2004 and 2016, in ambulatory of Department of Ophthalmology of the same Hospital. The age of patients was between 7 and 17 years old. Three cases (boys) were treated by surgery - one patient with conjunctival malignant melanoma (histologically confirmed) derived from a pre-existing benign conjunctival nevus (diagnosed 1.5 years before), a patient was operated for aesthetic reasons (with histological diagnosis of compound conjunctival melanocytic nevus) and one boy was diagnosed of melanocytic conjunctival nevus. All cases operated had normal visual acuity and fundoscopy. There was no regional lymph node present in any case studied. The traditional method for clinical diagnosis of suspected pigmented conjunctival lesions was to remove these lesions surgically and to examine architectural and cytological features with light microscopy. We recommend an immunohistochemical staining for the detection of specific cellular antigens in conjunctival melanocytic tumors in children. The diagnosis, treatment and the follow-up of the patient were challenges for the ophthalmologist.
结膜黑素细胞性病变是非常多样的色素性肿瘤，包括良性、癌前和恶性肿瘤。本文旨在强调儿童结膜黑素细胞性肿瘤的临床和组织病理学方面。本研究是一项回顾性病例系列研究，从罗马尼亚雅西“圣斯皮里东”急诊医院眼科手术的15例结膜黑素细胞性肿瘤患者中选取3例患者。通过对PubMed/MEDLINE、谷歌学术和科学网进行电子检索，对该主题的英文或法文原创文章及综述进行了系统回顾。患者于2004年至2016年期间由同一位医生在同一家医院眼科门诊进行诊断。患者年龄在7至17岁之间。3例（均为男孩）接受了手术治疗——1例结膜恶性黑色素瘤患者（经组织学证实）源自先前存在的良性结膜痣（1.5年前诊断），1例患者因美容原因接受手术（组织学诊断为复合性结膜黑素细胞痣），1例男孩被诊断为结膜黑素细胞痣。所有接受手术的病例视力和眼底检查均正常。在所研究的任何病例中均未发现区域淋巴结。对于疑似色素性结膜病变的临床诊断，传统方法是手术切除这些病变，并通过光学显微镜检查其结构和细胞学特征。我们建议对儿童结膜黑素细胞性肿瘤进行免疫组织化学染色以检测特定细胞抗原。对患者的诊断、治疗和随访对眼科医生来说都是挑战。
