Case of Rapidly Expanding Conjunctival Malignant Melanoma Initially from Primary Acquired Melanosis Diagnosed 14 Years Earlier
Hironobu Jimura,1 Yuuki Mishima,1 Chie Sotozono,2 Akihide Watanabe,2 Jun Asai,3 Chiho Ohbayashi,4 Nahoko Ogata1 1Department of Ophthalmology, Nara Medical University, Nara, Japan; 2Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan; 3Department of Dermatology, Kyoto...
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doaj-83f213722dc141dd8d0204f9f523ea1c2021-05-30T20:11:24ZengDove Medical PressInternational Medical Case Reports Journal1179-142X2021-05-01Volume 1436136465300Case of Rapidly Expanding Conjunctival Malignant Melanoma Initially from Primary Acquired Melanosis Diagnosed 14 Years EarlierJimura HMishima YSotozono CWatanabe AAsai JOhbayashi COgata NHironobu Jimura,1 Yuuki Mishima,1 Chie Sotozono,2 Akihide Watanabe,2 Jun Asai,3 Chiho Ohbayashi,4 Nahoko Ogata1 1Department of Ophthalmology, Nara Medical University, Nara, Japan; 2Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan; 3Department of Dermatology, Kyoto Prefectural University of Medicine, Kyoto, Japan; 4Department of Diagnostic Pathology, Nara Medical University, Nara, JapanCorrespondence: Nahoko OgataDepartment of Ophthalmology, Nara Medical University, Nara, JapanTel +81-744-29-8884 (ext.3432)Fax +81-744-23-8032Email ogata@naramed-u.ac.jpAbstract: Primary acquired melanosis (PAM) of the conjunctiva is a potentially serious melanocytic lesion that can lead to the development of a melanoma. A 60-year-old woman noticed pigmentation of the conjunctiva of her left eye for more than 10 years. She underwent excisional biopsy combined with cryotherapy and was diagnosed with PAM without atypia by intraoperative consultation. She was followed for 7 years, and no changes were observed. Fourteen years after the initial biopsy, she noted a growing conjunctival tumor, and a melanoma was suspected. She underwent orbital exenteration and skin grafting procedures. Histopathological examination of the specimen led to a diagnosis of conjunctival malignant melanoma. Re-examination of the initial biopsy specimen revealed that there was a proliferation of melanocytes that partially expanded over the basal layer of the conjunctiva which had been diagnosed as PAM with moderate atypia. We conclude that this case of conjunctival PAM had progressed to a conjunctival malignant melanoma after 14 years. Pathological evaluation of intraepithelial lesions has its limitations; thus, cases of PAM, even in the absence of obvious atypia, require careful follow-up.Keywords: primary acquired melanosis, conjunctival malignant melanoma, malignant melanoma, conjunctival melanoma, conjunctival tumorhttps://www.dovepress.com/case-of-rapidly-expanding-conjunctival-malignant-melanoma-initially-fr-peer-reviewed-fulltext-article-IMCRJprimary acquired melanosisconjunctival malignant melanomamalignant melanomaconjunctival melanomaconjunctival tumor |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jimura H Mishima Y Sotozono C Watanabe A Asai J Ohbayashi C Ogata N |
spellingShingle |
Jimura H Mishima Y Sotozono C Watanabe A Asai J Ohbayashi C Ogata N Case of Rapidly Expanding Conjunctival Malignant Melanoma Initially from Primary Acquired Melanosis Diagnosed 14 Years Earlier International Medical Case Reports Journal primary acquired melanosis conjunctival malignant melanoma malignant melanoma conjunctival melanoma conjunctival tumor |
author_facet |
Jimura H Mishima Y Sotozono C Watanabe A Asai J Ohbayashi C Ogata N |
author_sort |
Jimura H |
title |
Case of Rapidly Expanding Conjunctival Malignant Melanoma Initially from Primary Acquired Melanosis Diagnosed 14 Years Earlier |
title_short |
Case of Rapidly Expanding Conjunctival Malignant Melanoma Initially from Primary Acquired Melanosis Diagnosed 14 Years Earlier |
title_full |
Case of Rapidly Expanding Conjunctival Malignant Melanoma Initially from Primary Acquired Melanosis Diagnosed 14 Years Earlier |
title_fullStr |
Case of Rapidly Expanding Conjunctival Malignant Melanoma Initially from Primary Acquired Melanosis Diagnosed 14 Years Earlier |
title_full_unstemmed |
Case of Rapidly Expanding Conjunctival Malignant Melanoma Initially from Primary Acquired Melanosis Diagnosed 14 Years Earlier |
title_sort |
case of rapidly expanding conjunctival malignant melanoma initially from primary acquired melanosis diagnosed 14 years earlier |
publisher |
Dove Medical Press |
series |
International Medical Case Reports Journal |
issn |
1179-142X |
publishDate |
2021-05-01 |
description |
Hironobu Jimura,1 Yuuki Mishima,1 Chie Sotozono,2 Akihide Watanabe,2 Jun Asai,3 Chiho Ohbayashi,4 Nahoko Ogata1 1Department of Ophthalmology, Nara Medical University, Nara, Japan; 2Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan; 3Department of Dermatology, Kyoto Prefectural University of Medicine, Kyoto, Japan; 4Department of Diagnostic Pathology, Nara Medical University, Nara, JapanCorrespondence: Nahoko OgataDepartment of Ophthalmology, Nara Medical University, Nara, JapanTel +81-744-29-8884 (ext.3432)Fax +81-744-23-8032Email ogata@naramed-u.ac.jpAbstract: Primary acquired melanosis (PAM) of the conjunctiva is a potentially serious melanocytic lesion that can lead to the development of a melanoma. A 60-year-old woman noticed pigmentation of the conjunctiva of her left eye for more than 10 years. She underwent excisional biopsy combined with cryotherapy and was diagnosed with PAM without atypia by intraoperative consultation. She was followed for 7 years, and no changes were observed. Fourteen years after the initial biopsy, she noted a growing conjunctival tumor, and a melanoma was suspected. She underwent orbital exenteration and skin grafting procedures. Histopathological examination of the specimen led to a diagnosis of conjunctival malignant melanoma. Re-examination of the initial biopsy specimen revealed that there was a proliferation of melanocytes that partially expanded over the basal layer of the conjunctiva which had been diagnosed as PAM with moderate atypia. We conclude that this case of conjunctival PAM had progressed to a conjunctival malignant melanoma after 14 years. Pathological evaluation of intraepithelial lesions has its limitations; thus, cases of PAM, even in the absence of obvious atypia, require careful follow-up.Keywords: primary acquired melanosis, conjunctival malignant melanoma, malignant melanoma, conjunctival melanoma, conjunctival tumor |
topic |
primary acquired melanosis conjunctival malignant melanoma malignant melanoma conjunctival melanoma conjunctival tumor |
url |
https://www.dovepress.com/case-of-rapidly-expanding-conjunctival-malignant-melanoma-initially-fr-peer-reviewed-fulltext-article-IMCRJ |
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