Primary Acquired Melanosis of the Conjunctiva: Risks for Progression to Melanoma in 311 Eyes

Conjunctival melanoma and melanocytic intra-epithelial neoplasia

“…10 This pigmentation tends to 'wax and wane' with an increase and decrease in horizontal extension. 9 Not all conjunctival melanocytic lesions are pigmented, and involvement of the cornea is possible. 1,[11][12][13] …”

“…Some advocate periodic observation of small lesions. 9 The therapeutic methods include: excision with adjunctive cryotherapy, with or without an amniotic-membrane graft; 9,14,15 and topical chemotherapy with mitomycin C, 5-fluoro-uracil, and interferon alpha-2-beta. 10,[16][17][18] The current trend is towards topical chemotherapy.…”

“…9 The therapeutic methods include: excision with adjunctive cryotherapy, with or without an amniotic-membrane graft; 9,14,15 and topical chemotherapy with mitomycin C, 5-fluoro-uracil, and interferon alpha-2-beta. 10,[16][17][18] The current trend is towards topical chemotherapy. 17,19 In Liverpool, our practice is to perform mapping biopsies followed by topical chemotherapy with mitomycin C 0.04%, four times daily, in four 7-day cycles separated by rest periods of 3 weeks.…”

“…1,2,9,11,[22][23][24][25] CoM is a unilateral disease that usually presents in adulthood at a median age of 60 years and only rarely in childhood. 26 These tumours commonly arise in the perilimbal, …”

Melanose primária adquirida associada a erosões epiteliais recorrentes da córnea

“…Responde por aproximadamente 20 a 35% dos tumores conjuntivais pigmentados e o envolvimento corneano pode ser observado em cerca de 23% dos casos (2)(3)(4) . Histologicamente a MPA é classificada em dois tipos: MPA sem atipia, proliferação benigna de melanócitos normais restrita à camada basal da conjuntiva; e MPA com atipia, condição pré-maligna onde há aumento no número de melanócitos grandes, com nucléolos proeminentes e citoplasma abundante, podendo envolver todas as camadas da conjuntiva (crescimento pagetóide) (4,5) . Aproximadamente 13% dos casos de MPA conjuntival que apresentam atipias intensas evoluem para melanoma e cerca de 75% dos melanomas da conjuntiva evoluíram a partir de um quadro inicial de MPA (3,4) .…”