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Malignant melanoma of the conjunctiva with intraocular extension: a clinicopathological study of three cases

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Abstract

Background

Malignant melanoma of the conjunctiva is a rare tumour with an unpredictable behaviour, characterised by the high risk of local recurrence and metastatic spread. Intraocular extension of a conjunctival melanoma is rare. We present three cases of primary conjunctival melanoma with intraocular extension.

Methods

Three patients presented with primary conjunctival melanomas, which either arose at or later involved the limbus on a background of primary acquired melanosis. Despite adequate primary local excision and adjuvant chemotherapy, all three patients experienced several recurrences, requiring further surgery. Two of the patients had excision of the tumour that required superficial keratectomy. One of these patients then required two further procedures in which the anterior chamber was breached.

Results

All three patients ultimately required enucleation or exenteration to control local disease. All three specimens showed intraocular extension.

Conclusions

The management of conjunctival melanoma can be difficult. In addition to local recurrence and metastases, limbal melanomas may rarely show intraocular extension, particularly if surgery to excise the tumour requires the removal of Bowman’s membrane. Regular follow-up of these patients is mandatory.

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Acknowledgement

We are grateful to Dr. Jan Kerr for her advice on one of the cases.

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Authors and Affiliations

  1. Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, Scotland, UK

    Teresa Sandinha, Heather Russell & Ewan Kemp

  2. University Department of Pathology, Western Infirmary, Dumbarton Road, Glasgow, G11 6NT, Scotland, UK

    Fiona Roberts

Authors
  1. Teresa Sandinha
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  2. Heather Russell
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  3. Ewan Kemp
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  4. Fiona Roberts
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Corresponding author

Correspondence to Fiona Roberts.

Additional information

T. Sandinha and H. Russell have contributed equally to this work.

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Sandinha, T., Russell, H., Kemp, E. et al. Malignant melanoma of the conjunctiva with intraocular extension: a clinicopathological study of three cases. Graefe's Arch Clin Exp Ophthalmol 245, 431–436 (2007). https://doi.org/10.1007/s00417-006-0401-8

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  • DOI: https://doi.org/10.1007/s00417-006-0401-8

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