Giant Conjunctival Nevus in a 12-Year-Old Child

Abstract

We describe a case of a giant conjunctival nevus presented in a 12-year-old girl with suspicious clinicomorphological appearance. The lesion was noticed by the parents at the age of 3 years as a “fleshy spot” on the bulbar conjunctiva. The lesion remained unchanged until approx. 6 months before recent admission. On slit-lamp examination, a large conjunctival lesion with variegate pigmentation and indistinct margins was detected on the superonasal part of the bulbar conjunctiva of the left eye. Intralesional cysts and vessels were detected with AS-OCT examination. Wide excision and cryotherapy to the scleral bed were performed and amniotic membrane graft was used to restore the ocular surface. Histopathological examination revealed compound type conjunctival nevus and disclosed any sign of malignancy. Although giant conjunctival nevus is a rare entity, precise diagnosis and adequate management are very important as it can be confused with malignant melanoma.

Case of a Giant Conjunctival Melanocytic Nevus

“…The giant mass showed a hyperintense signal on T1 imaging and an iso-to hyperintense signal on T2 imaging (yellow arrows). Giant conjunctival nevi can be confused with conjunctival malignant melanoma clinically [3][4][5]. Malignant melanoma is one of the most severe life-threatening diseases.…”

“…Giant conjunctival nevi can be confused with conjunctival malignant melanoma clinically [3-5]. Malignant melanoma is one of the most severe life-threatening diseases.…”

“…In the present case, the progressive findings of enlargement during adulthood (from 5 mm in childhood to 15 mm at 78 years), a lack of cysts by slit-lamp microscopic examination, and older age could be used to avoid clinically diagnosing conjunctival melanocytic nevi as conjunctival malignant melanoma. In particular, intra­lesional cysts strongly suggest conjunctival melanocytic nevi [3, 5, 7]. Recently, the use of anterior segment optical coherence tomography (AS-OCT) has been found to reliably detect intralesional cysts [3, 5].…”

“…Most observed conjunctival melanocytic nevi are small [1, 2]; conjunctival nevi ≥10 mm in basal diameter are called “giant” conjunctival nevi [3]. In the case of large conjunctival melanocytic tumors, it is difficult to distinguish between conjunctival malignant melanoma and giant conjunctival melanocytic nevi clinically [3-5]. Herein, we describe a rare case of giant conjunctival melanocytic nevus that was suspected to be conjunctival malignant melanoma clinically and diagnosed as benign by histopathological examination.…”

Pigmentsejt-eredetű szemfelszíni elváltozások differenciáldiagnózisa és kezelése

“…Változó pigmentáltságú kerek vagy poligonális sejtekből áll, melyek elrendeződése a "sima" szerzett naevuséhoz ÖSSZEFOGLALÓ KÖZLEMÉNY hasonló (lásd alább), azonban a "sima" congenitalis naevusok hipercellulárisabbak. Többnyire számos, nagy junkcionális sejtfészekből állnak [12].…”