—I would like to thank Bernardino et al for their essentially favorable response to my editorial on conjunctival melanoma. It is not surprising (and was an intended beneficial effect) that some differences of opinion would be generated as a result of the editorial, particularly in view of the still unsettled state of the topic. I regard most of their points as nuances and one or two as major substantive disagreements. Despite the thrust of my amplifications and rebuttals, I would like to state that our positions on this subject converge more than diverge.
The radial growth phase (RGP) represents the earliest stage of cutaneous and conjunctival melanomas wherein the atypical or dysplastic melanocytes initially proliferate within the epidermis or epithelium and spread within these tissue planes to create a flat lesion. Ackerman and Su' have argued against the term "radial" because it implies growth in all directions
Jakobiec FA. Conjunctival Melanoma-Reply. Arch Ophthalmol. 1981;99(3):513-516. doi:10.1001/archopht.1981.03930010514031