Histopathological analysis of juvenile patients with melanocytic lesions of the conjunctiva

Abstract

Objective: This study aimed to examine the frequency of atypical features in conjunctival nevi in pediatric patients referred to the McGill University Health Center-McGill University Ocular Pathology and Translational Research Laboratory and to emphasize the importance of histopathological analysis to rule out malignant lesions, such as melanoma.Methods: Forty-four pediatric patients younger than 20 years of age previously diagnosed with melanocytic lesions of the conjunctiva were included in this study, and the database was analyzed for a 10-year period (2006–2015). Clinical information such as age, gender, location, type, size, and agreement between clinical and pathological diagnosis was also recorded and presented as means and percentages.Results: The mean age was 11.3 years, of which only 9.1% were older than 18 years. Gender predilection was found toward males (52.3%). An agreement was noted between clinical and pathological diagnosis in 77.2% of cases; only 22.72% showed atypia upon histopathological examination. The most common pathological diagnosis was compound nevus with different characteristics. The atypical lesions included conjunctival melanoma, junctional nevi with atypia, compound nevi with atypia, and cystic compound nevi. Moreover, 70% of the patients with atypical lesions were males and 60% of the specimens were from the right eye.Conclusion: An impressive number of 30% of all patients had some type of atypia after histopathological analysis. Therefore, based on these results, it is of extreme importance that all melanocytic lesions are sent for histopathological analysis, so an accurate diagnosis can be established.