Englisch Colya N, Berger Tim, Flockerzi Fidelis, Bofferding Max, Seitz Berthold
Department of Ophthalmology, Saarland University, 66421 Homburg, Saar, Germany.
Department of Experimental Ophthalmology, Saarland University, 66421 Homburg, Saar, Germany.
Am J Ophthalmol Case Rep. 2024 Aug 30;36:102162. doi: 10.1016/j.ajoc.2024.102162. eCollection 2024 Dec.
Conjunctival melanoma with large corneal involvement is a rarity. We here present a case of conjunctival melanoma with pronounced central corneal involvement.
A 69-year-old fair white male presented with a visual axis impeding corneal nodular lesion with associated conjunctival melanosis. Tumor excision with intraoperative mitomycin c (0.02 %) application for 180 seconds and amniotic membrane transplantation for defect coverage was performed in retrobulbar anesthesia. Histopathological evaluation revealed the nodular lesion to be a conjunctival melanoma (pT1a) with associated conjunctival melanocytic intraepithelial lesion (C-MIL).
Most conjunctival melanomas with corneal affection reach a radial corneal involvement of 1 mm. The here reported case accounted for 4 mm, which is seldom and therefore an important report. Surgical excision followed by intraoperative and postoperative mitomycin c exposure was a successful primary treatment. Currently there are no signs of tumor relapse in any part of the eye or the organism 12 months after excision. However, the long-term follow-up needs to be awaited.
累及角膜范围较大的结膜黑色素瘤较为罕见。我们在此报告一例累及角膜中央且范围明显的结膜黑色素瘤病例。
一名69岁的白人男性，因视轴受影响出现角膜结节性病变，并伴有结膜黑变病。在球后麻醉下进行肿瘤切除，术中应用丝裂霉素C（0.02%）180秒，并采用羊膜移植覆盖缺损。组织病理学评估显示，该结节性病变为结膜黑色素瘤（pT1a），伴有结膜黑色素细胞上皮内病变（C-MIL）。
大多数累及角膜的结膜黑色素瘤角膜径向受累范围达1毫米。本报告的病例累及范围达4毫米，实属罕见，因此是一份重要报告。手术切除并在术中及术后应用丝裂霉素C是一种成功的初始治疗方法。切除术后12个月，眼部或机体任何部位均无肿瘤复发迹象。然而，仍需进行长期随访。
