Melanoma of the conjunctiva

Melanoma of the conjunctiva is approximately 2% of the eye malignant tumors.

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Symptoms of conjunctival melanoma

Melanoma of the conjunctiva manifests itself in the 6th decade of life, excluding patients with dysplastic nevus syndrome, in whom multiple melaiomas develop much earlier. There is a single, black or gray nodule containing a feeding vessel that can be fixed to the episcler. Non-pigmentary tumors of pink color have a characteristic smooth appearance, similar to "salmon fillet". The tumor is most often located in the limb area, although it can occur on the conjunctiva anywhere.

Differential diagnosis of conjunctival melanoma

• A large nevus that grows during puberty, however, unlike melanoma, it does not affect the cornea.
• Melanoma of the ciliary body with extraocular proliferation.
• Melanocyte is a rare, congenital, slowly growing formation, almost black in color, which does not freely move around the eyeball.
• Pigmented conjunctival carcinoma in black skin.

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Classification of conjunctival melanoma

• Melanoma as a result of the regeneration of PP with atypical signs is 75% of cases.
• Melanoma as a result of malignification of the previously existing nevus is 20% of cases.
• Primary melanoma is the least common.

[11], [12], [13], [14]

Treatment of conjunctival melanoma

Treatment of Oranic Conjunctival Melanoma

1. Surgical wide excision with cryotherapy in order to reduce the risk of relapse.
2. If histological studies indicate incomplete excision, extensive re-excision of the surgical scar within a healthy tissue with further cryotherapy is shown.

Repeated examinations - every 6-12 months during life. At each visit, the entire conjunctival surface is examined. Each suspicious region is examined histologically after taking a biopsy or impression cytology.

Treatment of Conjunctival Diffuse Melanoma

Carry out excision of nodules in combination with cryotherapy and mitomycin C applications.

Relapses: resection and radiation therapy. Evisceration does not increase the degree of survival, so it is performed only in cases of extensive and progressive spread of the disease, when it is impossible to apply other methods.

The involvement of the lymph node is treated surgically (by excision) and radiotherapy.

Palliative treatment for metastasis: chemotherapy.

Prognosis of conjunctival melanoma

Lethality (approximately): 12% of cases for 5 years and 25% for 10 years. The main places of metastasis are regional lymph nodes, lungs, brain and liver.

Symptoms indicating a poor prognosis of conjunctival melanoma:

• Multifocal tumors.
• Extralimbal tumors affecting the meat, vault or palpebral conjunctiva.
• Density of the tumor is 2 mm or more.
• Relapse.
• Spreading on other tissues of the eye and lymph nodes.