Ch 40. Melanotic Neoplasms of the conjunctiva Flashcards
How are concjuntival nevi classified?
Junctional: in the dermal-epidermal junction
Subepithelial: Fully stromal.
Combined: a combination of the first two
Blue: episcleral.
Cellular Blue: spindle-cell episcleral.
What is another name for congenital EPITHELIAL conjuntival melanosis?
Ephelis, or conjunctival freckle.
A congenital, benign, non-progressive lesion.
is congenital melanosis (melanosis Oculi) benign or malignant?
melanosis oculi (Subepithelial, congenital, conjunctival melanosis) is benign in nature but has a potential for malignant transformation that usually arises in the uveal tract or orbit.
Is secondary acquired melanosis a benign or malignant lesion?
Bening
What is the usual presentation of secondary acquired melanosis?
What is the clinical presentation of primary aquired melanosis?
A yellow-brown, flat, diffuse pigmentation of the conjunctiva, not necessarily restricted to the sun-exposed limbus as is common with secondary acquired melanosis.
Presents in white patients, approx 56 years of age
what is the malignant potential at 10-year of PAM, according to shields et all…
12%
And there is an association between risk, and the number of affected clock hours.
management of PAM?
Due to the risk of malignant transformation, treatment is block-excision + crio or MMC.
what is the most important risk factor for ocular surface melanoma?
PAM (present in up to 2/3 of melanomas)
What is the most common rute for metastasis in conjunctival melanomas?
As with skin melanomas,the lymphatic spread is most likely.
They can also invade into the orbit & paranasal sinuses
What is the most important prognostic factor for mortality in conjunctival melanoma?
Lesion Thickness (higher than 1.8mm has high mortality risk)
