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ARTICLES
Year : 1974  |  Volume : 22  |  Issue : 2  |  Page : 38-39

Malignant melanoma of palpebral conjunctiva


Department of Ophthalmology, Government Medical College, Nagpur, India

Correspondence Address:
B U Padmawar
Department of Ophthalmology, Government Medical College, Nagpur
India
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Source of Support: None, Conflict of Interest: None


PMID: 4461694

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How to cite this article:
Padmawar B U, Sule S V, Ayachit R K, Shivde A V, Jejurikar D A. Malignant melanoma of palpebral conjunctiva. Indian J Ophthalmol 1974;22:38-9

How to cite this URL:
Padmawar B U, Sule S V, Ayachit R K, Shivde A V, Jejurikar D A. Malignant melanoma of palpebral conjunctiva. Indian J Ophthalmol [serial online] 1974 [cited 2021 Jan 21];22:38-9. Available from: https://www.ijo.in/text.asp?1974/22/2/38/31367

Malignant melanoma of conjunctiva is far less frequently encountered but is one of the most serious of ocular neoplasms.

Here is a report of an interesting case of malignant melanoma of palpebral conjunctiva with secondaries.


  Case Report Top


M.S., 52 years, Hindu male was admitted to the hospital with complaints of swelling of left eye for last 6 months. It started with incidental trauma by cow's horn. Prior to this development patient had not noticed any pigmentation or discolouration of conjunc­tiva. He had no other complaint. Past and family history did not reveal anything abnormal. On examina­tion of the left eye there was a soft to firm black growth which was encapsulated and lobulated with haemorrhagic spots on its surface. The growth was extending from caruncle to lateral canthus all over the bulbar conjunctiva more prominently in the lower part. The lower fornix and lower palpebral conjunctiva were completely obliterated. The upper lid and upper fornix were normal. The growth was extending all round the limbus more so on the nasal part. The eye ball was pushed up and out. Lens showed early lenti­cular opacities. The rest of the eye was normal. Right eye showed a light pigmented triangular patch on conjunctiva with base at Limbus extending from 6 O'clock to 8 O'clock.

Within 10 days of admission the growth completely covered the cornea.

General Examination showed marked pallor and koilonychia. The left preauricular and submaxillary glands were enlarged, firm and mobile. Liver was not palpable. Other systems were normal.

Total and differential leucocyte counts were normal. X-ray chest and orbit were normal. Blood haemoglo­bulin was 35%. Sigmoidoscopy did not reveal anything abnormal.

The exentration of the orbit with block dissection was carried out. The lacrimal bone, maxila and man­dible showed the blackish discolouration suggestive of secondaries. Preauricular glands were black in colour and showed gross infiltration by malignant cells. Patient was put on Endoxon. He did not come for follow up.

Histopathology:-On histopathological examination the size of eye ball was normal. The cut section of eye ball showed that it was completely free from the tumour and did not reveal any invasion by tumour tissue. The tumour mas was mainly composed of large spindle cells with abundent cytoplasm and large vesi­cular nuclei with hyperchromatism and active mitosis. The cytoplasm showed sprinkling with coarse brown black melanin granules. The cells were arranged in fascicular bundles. These histological features were observed in the tumour tissue just beneath the conjunc­tival epithelium. The deeper cells were spindle shaped and densely loaded with jet black melanin pigments completely obliterating their marphology. The section from the palpebral conjuntiva showed presence of intense melanotic pigmentation and dysplasia. The cells gave vacuolated appearance with hyperchroma­tism and mitosis. Large atypical melanocytes were seen to form the small intraepithelial nests. These features were suggestive of acquired melanosis.


  Discussion Top


The largest series of melanomas has been reported by Jay from Institute of Ophthal­mology, London. Incidence of conjunctival melanoma was only 1:20 of ocular melanomas. Melanoma of the palpaberal conjunctiva was still rarer. Incidence of melanomas in neg­roes is considerably less as compared to that of white races [3] .


  Summary Top


An interesting case of malignant melanoma of conjunctiva arising from palpebral conjunc­tiva in acquired pre-cancerous melanosis is reported. The patient had secondaries in preauricular and submixillary glands and maxillary and mandibular bones. The eye ball was completely free from invasion of tumour tissue.

 
  References Top

1.
B. Jay, 1965, Brit !. Ophthal. 49, 169.  Back to cited text no. 1
    
2.
Reese A. B. 1938, Arch. Ophthal. 19, 352. 1943, ibid. 29, 737. 1963, Tumours of Eye, 2nd Ed. 335.  Back to cited text no. 2
    
3.
Z. Wessely 1959, Arch. of Ophthal. 62, 697.  Back to cited text no. 3
    


    Figures

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



 

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