Alhamood Mohammed, Sbh Bashar, Muhammad Ali, Saadeh Imad
Department of Neurology, Tishreen Military Hospital, Damascus, Syrian Arab Republic.
Department of Ophthalmology, Tishreen Military Hospital, Damascus, Syrian Arab Republic.
J Med Case Rep. 2025 Jul 20;19(1):355. doi: 10.1186/s13256-025-05421-w.
Conjunctival melanoma is a rare yet aggressive ocular surface malignancy, with an incidence of approximately 0.2-0.8 cases per million individuals annually. It predominantly affects older adults, making its occurrence in younger individuals exceedingly rare and diagnostically challenging.
We report a 30-year-old Syrian male presenting with a progressively enlarging pigmented lesion on the temporal-inferior conjunctiva of the right eye. The lesion, noted since adolescence, demonstrated significant growth over the past 3 years. Comprehensive clinical assessment and imaging studies confirmed the presence of a well-vascularized, mobile conjunctival lesion, with no evidence of intraocular extension. Surgical excision with 1 mm safety margins was performed, followed by ocular surface reconstruction using a cryopreserved amniotic membrane graft. Histopathological analysis revealed a malignant melanoma with epithelioid and spindle cell morphology and tumor-free margins. Postoperative recovery was uneventful, with full epithelialization by 1 week and no evidence of recurrence at the 1-year follow-up.
Timely diagnosis and a multidisciplinary surgical approach are essential for achieving optimal outcomes in conjunctival melanoma, particularly in young patients. Complete excision with negative margins combined with amniotic membrane grafting ensures effective oncologic control and functional ocular surface restoration.
结膜黑色素瘤是一种罕见但侵袭性强的眼表恶性肿瘤，每年每百万人口中的发病率约为0.2 - 0.8例。它主要影响老年人，在年轻个体中极为罕见且诊断具有挑战性。
我们报告一名30岁的叙利亚男性，其右眼颞下结膜有一个逐渐增大的色素沉着病变。该病变自青春期起就已被发现，在过去3年中显著增大。全面的临床评估和影像学检查证实存在一个血管丰富、可移动的结膜病变，无眼内扩展的证据。进行了带1毫米安全切缘的手术切除，随后使用冷冻保存的羊膜移植进行眼表重建。组织病理学分析显示为具有上皮样和梭形细胞形态且切缘无肿瘤的恶性黑色素瘤。术后恢复顺利，1周时完全上皮化，1年随访时无复发迹象。
对于结膜黑色素瘤，尤其是年轻患者，及时诊断和多学科手术方法对于取得最佳治疗效果至关重要。切缘阴性的完整切除联合羊膜移植可确保有效的肿瘤控制和功能性眼表修复。
