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Year : 1960  |  Volume : 8  |  Issue : 4  |  Page : 92-93

Malignant melanoma of the limbus

Sarojini Devi Hospital and Institute Of Opthalmology and Otolaryngology,Hyderabad, India

Date of Web Publication5-May-2008

Correspondence Address:
B K Phatak
Sarojini Devi Hospital and Institute Of Opthalmology and Otolaryngology,Hyderabad
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How to cite this article:
Phatak B K, Satyendran O M. Malignant melanoma of the limbus. Indian J Ophthalmol 1960;8:92-3

How to cite this URL:
Phatak B K, Satyendran O M. Malignant melanoma of the limbus. Indian J Ophthalmol [serial online] 1960 [cited 2023 Dec 8];8:92-3. Available from: https://journals.lww.com/ijo/pages/default.aspx/text.asp?1960/8/4/92/40673

Malignant pigmented neoplasms are seen rarely in this hospital. During the past twelve months six thousand in­patients and over thirty-six thousand out-patients were treated in the eye department. During this period the pathology register records only two other cases of malignant melanomata of the eye and its adnexa.

The patient, a man named Chenniah, aged 60 cultivator by profession com­plained of a growth in his right eye. He had noticed a dark spot in the same eye since birth but during th past eight months it had begun to grow rapidly.

The tumour was a brownish-black cylindrical mass astride the limbos on the temporal side and protruded for­wards between the lid margins to a length of 18 nun [Figure - 1],[Figure - 2]. Its base was roughly circular, about i cm across, extending from the outer third of the cornea across the limbos to the bulbar conjunctiva. It presented a shin­ing smooth lobulated surface. About 2 min of the cornea around the base had a brownish black appearance. Prominent tortuous conjunctival blood vessels led to the base of the neoplasm. The visual acuity in the eye was 6/60. Because of this, considerable per­suasion had to be exercised before the patient consented to the removal of the eye.

Histological sections of the eyeball were made in the parasagital plane. The cellular details were obscured by heavy dark brown granular pigment. Bleaching of the pigment revealed epitheliod type cells in a sheet like arrangement [Figure - 3]. The cytoplasmic outlines were indistinct. The nuclei which were clearly demarcated con­tained one or two nucleoli. The over­lying stratified epithelium whose base­ment membrane was intact, did not present any abnormality [Figure - 4]. 1nfelaiorly, adjacent to the base of the neoplasm the corneal epithelium pre­sented changes similar to those of pre­cancerous melanosis [Figure - 5]. There was intraepithelial proliferation of cells with cytoplasmic vacuolation and con­taining granular dark-brown pigment. The cell; were arranged in small groups within the epithelium.

Reese, (1953) states that a malig­nant me!anoma of naevus origin is a localized, elevated aid sometimes pedunculated single or multiple tumour mass showing varying amounts of pig­mentation and composed of large nucleolated cells with well demarcated borders. But, according to him, it is a rare occurrence for a pre-existing naevus to develop into a malignant tumour. The history, clinical signs and the lustological features in this case favour the diagnosis of a malig­nant melanoma arising from a pre­existing nevus. The precancerous changes are seen only in the epithelium adjacent to the base of the neoplasm and not within the epithelium over­lying it. It is probable that these changes were excited concurrently with or after the malignant transformation of the naevus. A case in which one eye presented a malignant melanoma at the limbo, on one side and exhibited pre-cancerous changes in the corneal epithelium on the opposite side has been reported by Schofield. (1958).

Although the tumour had been grow­ing for eight months and had attained a length of 18 mm only the anterior layers of the corneal stroma were in­filtrated, the globe and its contents remaining uninvaded. Whether pre­cancerous changes were present in the bulbar conjunctiva was not ascertained by sections in the horizontal plane. As an enucleation of the eye-ball was carried out instead of an exenteration of the orbit (Reese 1953) it is hoped that the conjunctiva removed with the globe has been adequate.[3]

  References Top

Duke Elder S. (1939) Text Book of Ophthalmology-" P. 1807, Kimpton, London,  Back to cited text no. 1
Reese, A. B. (1953) "Tumours of the Eye" p. 330, Paul B. Hoeber, U.S.A.  Back to cited text no. 2
Schofield, P. B. (1958)"Brit. J. Ophthal", 42, 99.  Back to cited text no. 3


  [Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4], [Figure - 5]


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