Kharmach Ikram, Rezzoug Fatima, Moukhlissi Mohamed, Al Jarroudi Ouissam, Brahmi Sami Aziz, Afqir Said
Medical Oncology, Mohammed VI University Hospital, Oujda, MAR.
Medical Oncology, Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, MAR.
Cureus. 2024 Jun 13;16(6):e62331. doi: 10.7759/cureus.62331. eCollection 2024 Jun.
Conjunctival melanoma is a rare but aggressive condition that can arise from healthy conjunctiva, pre-existing nevi, or precancerous conditions like Reese's melanosis. This acquired primary conjunctival melanosis can significantly impact an individual's quality of life due to its potential for recurrence and metastasis. Effective treatment typically requires a multidisciplinary approach to optimize outcomes. We present the case of a 56-year-old patient with recurrent Reese melanoma who underwent multiple surgeries. During the last intervention, a malignant transformation into melanoma was discovered. Due to the absence of brachytherapy facilities, the patient received local treatment with mitomycin C eye drops. Despite this limitation, the patient showed no signs of recurrence one year post-treatment. Given the high risk of local recurrence after surgery alone, additional radiotherapy is recommended and should be systematically discussed. Regular monitoring and timely intervention are essential to prevent disease progression. Notably, the frequent BRAF (B-Raf proto-oncogene, serine/threonine kinase) mutation in conjunctival melanoma opens possibilities for targeted therapies, such as BRAF inhibitors, offering promising options for management alongside traditional surgical approaches.
结膜黑色素瘤是一种罕见但侵袭性很强的疾病，可起源于健康的结膜、既往存在的痣或如里斯黑色素沉着症等癌前病变。这种后天性原发性结膜黑色素沉着症因其复发和转移的可能性，会对个人生活质量产生重大影响。有效的治疗通常需要多学科方法来优化治疗效果。我们报告一例56岁复发性里斯黑色素瘤患者，该患者接受了多次手术。在最后一次干预中，发现发生了恶性转化为黑色素瘤。由于缺乏近距离放射治疗设备，该患者接受了丝裂霉素C滴眼液局部治疗。尽管有此限制，但患者在治疗后一年未出现复发迹象。鉴于单纯手术后局部复发风险高，建议进行额外放疗，且应进行系统讨论。定期监测和及时干预对于预防疾病进展至关重要。值得注意的是，结膜黑色素瘤中频繁出现的BRAF（B-Raf原癌基因，丝氨酸/苏氨酸激酶）突变为靶向治疗开辟了可能性，如BRAF抑制剂，为与传统手术方法一起的治疗管理提供了有前景的选择。
