Document Type : Case Reports


Department of Pathology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran


Conjunctival melanoma is an uncommon tumor that is likely to recur and carries an overall mortality rate of approximately 30%. Melanoma   arises from melanocytes, most often in sun-exposed skin. Less commonly, melanoma originates from other tissues such as the uvea, rectum, mouth, respiratory tract, and conjunctiva. Conjunctival melanoma represents only 1.6% of all noncutaneous melanoma. Herein, we reported a case of conjunctival melanoma followed by reviewing the literature to provide an optimal diagnostic approach.


Main Subjects

  1. Shields CL, Shields JA. Tumors of the conjunctiva and cornea. Indian J Ophthalmol. 2019;67(12):1930. [DOI:10.4103/ijo.IJO_2040_19] [PMID]
  2. Ciuntu RE, Martinescu G, Anton N, Danciu M. Conjunctival melanocytic tumors in children-a challenge in diagnosis and treatment. Rom J Morphol Embryol. 2018;59(1):317-22.
  3. Berta-Antalics A, Kruse F, Holbach L. Pathology and prognostic factors of conjunctival melanoma. Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft. 2015;112(11): 892, 4-8. [DOI:10.1007/s00347-015-0148-x] [PMID]
  4. Shields CL, Shields JA, Gündüz K, Cater J, Mercado GV, Gross N, et al. Conjunctival melanoma: risk factors for recurrence, exenteration, metastasis, and death in 150 consecutive patients. Arch Ophthalmol. 2000;118(11):1497-507. [DOI:10.1001/archopht.118.11.1497] [PMID]
  5. Seregard S. Conjunctival melanoma. Surv Ophthalmol. 1998;42(4):321-50. [DOI:10.1016/S0039-6257(97)00122-7] [PMID]
  6. Shields JA, Shields CL, Mashayekhi A, Marr BP, Benavides R, Thangappan A, et al. Primary acquired melanosis of the conjunctiva: experience with 311 eyes. Trans Am Ophthalmol Soc. 2007;105:61.
  7. Jakobiec FA, Folberg R, Iwamoto T. Clinicopathologic characteristics of premalignant and malignant melanocytic lesions of the conjunctiva. Ophthalmology. 1989;96(2):147-66. [DOI:10.1016/S0161-6420(89)32920-4] [PMID]
  8. Jakobiec FA, Rini FJ, Fraunfelder FT, Brownstein S. Cryotherapy for conjunctival primary acquired melanosis and malignant melanoma: experience with 62 cases. Ophthalmology. 1988;95(8):1058-70. [DOI:10.1016/S0161-6420(88)33058-7] [PMID]
  9. Folberg R, McLean IW, Zimmerman LE. Primary acquired melanosis of the conjunctiva. Hum Pathol. 1985;16(2):129-35. [DOI:10.1016/S0046-8177(85)80061-7] [PMID]
  10. Savar A, Esmaeli B, Ho H, Liu S, Prieto VG. Conjunctival melanoma: local-regional control rates, and impact of high‐risk histopathologic features. J Cutan Pathol. 2011;38(1):18-24. [DOI:10.1111/j.1600-0560.2010.01625.x] [PMID]
  11. Tuomaala S, Kivelä T. Metastatic pattern and survival in disseminated conjunctival melanoma: implications for sentinel lymph node biopsy. Ophthalmology. 2004;111(4):816-21. [DOI:10.1016/j.ophtha.2003.11.001] [PMID]
  12. Boccard R, Nores J, Kantelip B, Bacin F, Guilaine J, editors. Conjunctival localization of Spitz nevus. Ann Dermatol Venereol; 1988.
  13. Jakobiec FA, Zuckerman BD, Berlin AJ, Odell P, MacRae DW, Tuthill RJ. Unusual melanocytic nevi of the conjunctiva. Am J Ophthalmol. 1985;100(1):100-13. [DOI:10.1016/S0002-9394(14)74991-8] [PMID]
  14. Jakobiec FA, Bhat P, Colby KA. Immunohistochemical studies of conjunctival nevi and melanomas. Arch Ophthalmol. 2010;128(2):174-83. [PMID] [DOI:10.1001/archophthalmol.2009.394]
  15. Souza L, Coutinho S, dos Santos Medeiros S, De Figue-iredo Cavalcanti H, De Miranda R. Conjunctival Melanoma and Role of Immunohistochemical Markers protein S100, HMB-45 and Melan A in Tumor Staging: Case Report and Literature Review. J Surg Curr Trend Innov 3: 011. Received: February. 2019;6. [DOI:10.24966/SCTI-7284/100011]
  16. Barnhill RL. The Spitzoid lesion: rethinking Spitz tumors, atypical variants,'Spitzoid melanoma'and risk assessment. Mod Pathol. 2006;19(2):S21-S33. [DOI:10.1038/modpathol.3800519] [PMID]
  17. Colarossi C, Milazzo M, Paglierani M, Massi D, Memeo L, Canzonieri V. A juvenile case of conjunctival atypical nevus. Diagn Pathol. 2013;8(1):1-4. [DOI:10.1186/1746-1596-8-64] [PMID]
  18. Morkin MI, Hofmann RJ, Laver NV. Subepithelial conjunctival nevus with atypia: Expanding our understanding of a challenging diagnosis. Hum Pathol Case Rep. 2018;13:56-9. [DOI:10.1016/j.ehpc.2018.05.001]
  19. Vervaet N, Van Ginderdeuren R, Van Den Oord J, Foets B. A rare conjunctival Spitz nevus: a case report and literature review. Bull Soc Belge Ophtalmol. 2007;303(303):63-7