CONJUNCTIVAL AMELANOTIC MALIGNANT-MELANOMA ARISING IN PRIMARY ACQUIRED MELANOSIS SINE PIGMENTO

Authors
Citation
V. Jay et Rl. Font, CONJUNCTIVAL AMELANOTIC MALIGNANT-MELANOMA ARISING IN PRIMARY ACQUIRED MELANOSIS SINE PIGMENTO, Ophthalmology, 105(1), 1998, pp. 191-194
Citations number
5
Categorie Soggetti
Ophthalmology
Journal title
ISSN journal
01616420
Volume
105
Issue
1
Year of publication
1998
Pages
191 - 194
Database
ISI
SICI code
0161-6420(1998)105:1<191:CAMAIP>2.0.ZU;2-G
Abstract
Background: The authors describe an amelanotic malignant melanoma of t he conjunctiva in association with primary acquired melanosis (PAM) si ne pigmento, and highlight the clinical and pathologic features of thi s rare entity. Methods: Histopathologic and immunohistochemical studie s were performed on a conjunctival tumor in a 54-year-old white woman. Study Design: Case report. Results: Histopathologic examination revea led an invasive amelanotic melanoma of the conjunctiva, with anterior orbital extension arising from intraepithelial dysplastic melanocytes that lacked melanin pigment (PAM sine pigmento). Both the malignant me lanoma cells and the intraepithelial dysplastic melanocytes in the are as of PAM exhibited S-100 and HMB-45 positivity, The patient underwent an orbital exenteration that disclosed tumor within the anterior orbi t inferiorly. Conclusions: Amelanotic invasive malignant melanoma can arise in association with PAM sine pigmento, as seen in our patient wh o had orbital invasion necessitating exenteration, This aggressive for m of conjunctival melanoma is often associated with a poor prognosis a nd risk of metastatic disease, Absence of conjunctival pigmentation in PAM sine pigmento prevents early clinical detection of this variant o f PAM, This lack of pigmentation also makes clinical diagnosis virtual ly impossible, and diagnosis can only be established histopathological ly, Awareness of this nonpigmented variety of PAM is crucial for early recognition and appropriate management of the associated melanoma.