Amelanotic conjunctival melanoma: diagnosis and therapeutic management

• Published in: Acta ophthalmologica (Oxford, England) England), 2012-09, Vol.90 (s249), p.0-0
• Main Authors: SATUE, M, BAMBO, M, ARA, M, EGEA, MC, FERNANDEZ‐PEREZ, S, HERRERO, R, GARCIA‐MARTIN, E, DE LA MATA, G
• Format: Article
• Language: English
• Subjects: Chemotherapy; Ophthalmology; Tumors
• ISSN: 1755-375X; 1755-3768
• DOI: 10.1111/j.1755-3768.2012.S004.x

Purpose To present a case report of a patient with atypical presentation of a conjunctival melanoma as an amelanotic tumor. Methods A 82‐year‐old female presenting a large amelanotic tumor in inferior tarsal conjunctiva of the right eye was referred to our hospital. Previous histological analysis diagnosed intraepithelial carcinoma. Imaging digital analysis techniques showed infiltration of the extrinsic ocular muscles but not the scleral tissue. Excisional biopsy was obtained by removing the tumor with free margins and preserving as many unaffected tissue as possible. Amniotic membrane graft was used to cover the surgical injury. Results Histopathological diagnosis confirmed amelanotic conjunctival melanoma. Systemic evaluation with imaging techniques (MRI, TC scan, Ecography…) revealed liver and kidney masses suggestive of metastasis and chemotherapy was prescribed to control the disease. Ophthalmological controls showed remission of tumor for 4 months, but new conjunctival masses appeared. At the present the patient is treated with palliative chemotherapy. Age and systemic status do not allow aggressive therapies in this patient. Conclusion Amelanotic melanoma is an atypical subtype of melanoma lacking of pigmentation. Its macroscopic aspect makes it almost impossible to clinically distinguish this tumor from less aggressive tumors, such as intraepithelial carcinomas. The diagnosis delay makes early treatment difficult in this malignant tumors.