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Ophthalmic Images
November 10, 2016

Conjunctival Melanoma in a Black Patient

Author Affiliations
  • 1Institut Curie Paris, Université Paris-Descartes, Paris, France
  • 2Institut Curie Paris, Paris, France
JAMA Ophthalmol. 2016;134(11):e162726. doi:10.1001/jamaophthalmol.2016.2726

A black woman in her early 40s with an unremarkable medical history presented with a pigmented conjunctival lesion of the right eye that had been present since childhood but had been increasing in size for the past few months (Figure, A). Tumor excision was performed under general anesthesia (using a “no-touch technique” as described previously1,2). Histological analysis showed conjunctival melanoma (Figure, B). The clinical stage of the tumor was T1aN0M0 according to the seventh edition of the American Joint Committee on Cancer staging system for conjunctival melanoma.2 No mutations were found on the BRAF gene (exon 15), NRAS gene (codons 12, 13, 61, 117, and 146), or C-KIT gene (exons 11, 13, and 17). Adjuvant brachytherapy with iodine plaque was performed because of the invasion of the substantia propria.

Figure.
Primary melanoma of the bulbar conjunctiva in a black patient. A, Flat pigmented conjunctival lesion with irregular edges and heterogeneous pigmentation. Racial melanosis is also present. B, Histological analysis of the lesion showing conjunctival melanoma (in situ and invading the subepithelial connective tissue) (hematoxylin-eosin-saffron, original magnification ×100).

Primary melanoma of the bulbar conjunctiva in a black patient. A, Flat pigmented conjunctival lesion with irregular edges and heterogeneous pigmentation. Racial melanosis is also present. B, Histological analysis of the lesion showing conjunctival melanoma (in situ and invading the subepithelial connective tissue) (hematoxylin-eosin-saffron, original magnification ×100).

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Article Information

Corresponding Author: Stéphanie Lemaitre, MD, Institut Curie, Ophtalmology, Université Paris-Descartes, 26 rue d'Ulm, 75248 Paris Cedex 05, France (stefaniele@free.fr).

Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.

References
1.
Shields  JA, Shields  CL, De Potter  P.  Surgical management of conjunctival tumors: the 1994 Lynn B. McMahan Lecture. Arch Ophthalmol. 1997;115(6):808-815.
PubMedArticle
2.
AJCC-UICC Ophthalmic Oncology Task Force. Malignant melanoma of the conjunctiva. In: Edge  SE, Byrd  DR, Carducci  MA, Compton  CA, eds. AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer; 2009:539-546.
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