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Conjunctival and Corneal Tumors: Primary Acquired Melanosis

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Clinical Ophthalmic Oncology

Abstract

Conjunctival primary acquired melanosis (PAM) appears clinically as a flat and variegated brown usually monocular lesion, ranging from golden brown to dark chocolate, which may involve any area of the conjunctiva. PAM occurs typically in adults and elderly. PAM may remain stable for long periods of time or may grow in size. A “waxing and waning” phenomenon is well known; thus, the borders of the lesion often cannot be identified. The lesion designed as PAM clinically may feature no atypia histologically (PAM without atypia), or one detects melanocytic atypia histologically (PAM with atypia). PAM without atypia does not progress to melanoma, whereas PAM with atypia should be considered a melanoma precursor. Recently, the term “conjunctival melanocytic intraepithelial (C-MIN) with or without atypia” was suggested for histological use. There are no clinical criteria by which ophthalmologists can anticipate the histological diagnosis. Therefore, when PAM is suspected, the lesion should be biopsied. A small lesion should be completely excised, while in widespread lesions, incisional biopsies should be performed in various sites of the affected conjunctiva. In addition to surgical excision, cryotherapy may be performed, and in PAM with atypia, topical mitomycin C chemotherapy and in small series also topical interferon α-2b were found to be effective.

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Authors and Affiliations

  1. Ocular Oncology Service and Ophthalmic Pathology Laboratory, Department of Ophthalmology, Hadassah - Hebrew University Medical Center, Jerusalem, Israel

    Jacob Pe’er

  2. Oakland University William Beaumont School of Medicine, Rochester, MI, USA

    Robert Folberg

Authors
  1. Jacob Pe’er
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  2. Robert Folberg
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Correspondence to Jacob Pe’er .

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Editors and Affiliations

  1. Ocular Onocology Service and Ophthalmic Pathology Laboratory, Department of Ophthalmology, Hadassah - Hebrew University Medical Center, Jerusalem, Israel

    Jacob Pe'er

  2. Department of Ophthalmic Oncology, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA

    Arun D. Singh

  3. Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK

    Bertil E. Damato

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Pe’er, J., Folberg, R. (2019). Conjunctival and Corneal Tumors: Primary Acquired Melanosis. In: Pe'er, J., Singh, A., Damato, B. (eds) Clinical Ophthalmic Oncology. Springer, Cham. https://doi.org/10.1007/978-3-030-06046-6_16

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  • DOI: https://doi.org/10.1007/978-3-030-06046-6_16

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-030-06046-6

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