Vishnevskia-Dai Vicktoria, Davidy Tal, Zloto Ofira
Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Am J Ophthalmol Case Rep. 2022 Nov 11;29:101735. doi: 10.1016/j.ajoc.2022.101735. eCollection 2023 Mar.
Malignant melanomas of the conjunctiva are extremely rare in children. In this case report we present a conjunctival melanoma of a child.
We report a case of a 7 years old boy who presented with a rapidly growing reddish lesion measuring 8mm in base × 2.5 mm in thickness on the nasal conjunctiva in his right eye. The patient underwent resection of the lesion (with 4 mm margins of the surrounding clinically normal conjunctiva) and cryotherapy to the adjacent conjunctival margins. Histopathology confirmed the diagnosis of conjunctival melanoma. Pathology also can be challenging; a review of pathology is advisable as happened in this case. Systemic workup was negative for metastatic disease. On 73 months of follow up, the patient was stable without local recurrence or secondary systemic disease.
Malignant melanoma can present de novo as an amelanotic rapidly growing conjunctival lesion in children. This case should raise the awareness of the variable clinical presentations, the challenging diagnosis, treatment and follow up of pediatric conjunctival melanoma.
结膜恶性黑色素瘤在儿童中极为罕见。在本病例报告中，我们呈现了一名儿童的结膜黑色素瘤病例。
我们报告了一例7岁男孩，其右眼鼻侧结膜出现一个迅速生长的红色病变，基底尺寸为8mm×厚度为2.5mm。患者接受了病变切除（连同周围临床正常结膜的4mm边缘）以及对相邻结膜边缘的冷冻治疗。组织病理学确诊为结膜黑色素瘤。病理诊断也可能具有挑战性；如本病例所示，建议进行病理复查。全身检查未发现转移性疾病。在73个月的随访中，患者情况稳定，无局部复发或继发性全身疾病。
恶性黑色素瘤可在儿童中以无色素的迅速生长的结膜病变形式初发。该病例应提高对儿童结膜黑色素瘤可变临床表现、具有挑战性的诊断、治疗及随访的认识。
