Conjunctival Naevi Research Articles

Subepithelial melanocytic lesions in pterygium: A rare association

Abstract Pterygium is a wing-shaped fold of fleshy growth extending from the conjunctiva into the cornea. Most patients will have only minimal complaints, but can cause disturbances in vision due to astigmatism and by crossing the visual axis. Pterygium is caused by multiple factors, and ultraviolet light exposure plays a critical role. Most cases can be managed without complications. Pterygium often occurs with ocular surface abnormalities manifesting as dry eye, and limbal stem cell deficiency has been observed, but pterygium is very rarely associated with any pigmented lesions. We report a rare association of benign conjunctival melanocytic naevus within pterygium and its management. To our best knowledge, this association is not common and should be evaluated thoroughly to rule out malignant conditions.

Removal of Benign Conjunctival Naevus by Argon Laser Photocoagulation compared to Surgical Excision

Background: Conjunctival naevus is a widespread benign eye tumor. Surgical excision or argon laser photocoagulation are treatment choices for superficial and deep conjunctival naevi. Purpose: To compare between surgical excision and argon laser photoablation of conjunctival naevus concerning safety, efficacy and post removal complications. Patients & Methods: A randomized controlled trial was conducted in Ophthalmology Department, Al-Azhar University Hospitals, Egypt in the period from January 2022 till January 2023 included 40 patients presenting with benign pigmented conjunctival naevi formed of two groups; Group (1) included 20 patients and removal of conjunctival naevi by argon laser photocoagulation was done while group (2) included 20 patients and surgical excision of conjunctival naevi was done. Results: As regard to post removal complications, recurrence of naevi occurred in group (1) only, dry eye was higher in argon laser ablation than surgical excision (15% vs 5%), conjunctival inflammation was higher in excision than argon laser (20% vs 10%) and scaring occurred in surgical excision group only. Unsatisfaction was higher in surgical excision than laser ablation. Also, there was statistically significant difference between both groups as regard to complications. Conclusion: Argon laser ablation is a simple and efficient treatment of benign conjunctival naevi and may be used in chosen patients instead of a traditional surgical technique.

Invasive conjunctival melanoma mimicking ocular surface squamous neoplasia: a case series

BackgroundConjunctival melanoma is the second most common conjunctival malignant tumour after squamous cell carcinoma, usually arising from primary acquired melanosis and less commonly from a conjunctival naevus or de novo....

Balloon cell naevus of the conjunctiva: clinicopathological features and management

A 7-year-old Caucasian girl presented with a pigmented lesion on the left bulbar conjunctiva that increased in size from 1 mm to 4 mm over a 12-month period. She underwent excision biopsy and reconstruction of the ocular surface with amniotic membrane graft. Histopathology showed the naevus was composed of somewhat swollen naevus cells with clear cytoplasm and central nucleus. These vacuolated naevus cells were approximately 40 µm in diameter. Over 90% of the cells in the naevus were composed of these swollen cells. Immunohistochemical staining was positive for S100 and Melan-A. This case illustrates that balloon cells may be observed in conjunctival naevi at a previously unreported pre-pubescent age. Awareness of ballon cell naevus is important to avoid clinical and histological pitfalls in diagnosis.

Les tumeurs oculaires primitives de l'enfant: aspects épidémiologiques et histopathologiques à l'hôpital gynéco-obstétrique et pédiatrique de Yaoundé

The ocular tumours encountered in ophthalmologic consultations affect all age groups. The purpose of our study is to help improve knowledge of ocular and orbital tumours in children in Cameroon, by analysing the epidemiologic and histopathologic aspects of these tumours at the Yaoundé Gynaeco-Obstetric and Pediatric Hospital (HGOPY). We therefore conducted a retrospective descriptive cross-sectional study examining files of cases treated from 2003 through 2009. We found that tumours accounted for 0.36% of all consultations of children aged from 0 to 15 years in the HGOPY and affected an average of three children a year, mainly those younger than 10 years (90% of the cases) and 65% boys. Overall, 75% of the tumours were retinoblastomas (75%), 15% conjunctival naevi, 5% epidermoid carcinomas of conjunctiva (5%) and angioneurofibromas of the optic nerve (5%). Ocular tumours are rare in children attending hospitals in Cameroon. They are mainly retinablastinomas and affect boys more often than girls.

Histological criteria for grading of atypia in melanocytic conjunctival lesions

To develop a standardised protocol for grading atypia in melanocytic conjunctival lesions (MCL), mainly primary acquired melanosis (PAM) and inflamed juvenile conjunctival naevi (IJCN) and to establish prognostic parameters for progression to malignant melanoma (MM). A retrospective non-randomised study of 304 patients with MCL was conducted. Histological slides of MCL diagnosed as conjunctival naevus (CN; 222 cases), PAM (42 cases), and IJCN (40 cases) were reviewed. A scoring method of atypia was developed according to the following histological parameters: nest cohesion, melanocytic hyperplasia, nuclear features, and pagetoid spread. Lesions were scored according to the number of criteria as mild (1-2), moderate (3-4) and severe (5-8). Nineteen PAM lesions showed mild (n = 8), moderate (n = 4), and severe (n = 7) atypia. The remaining PAM lesions were without atypia. IJCN cases showed architectural disorder only. Neither architectural disorder nor cytological atypia were found in the CN. There were no recurrences in the IJCN and PAM lesions without and with mild atypia, while two PAM with moderate and two with severe atypia recurred. Three cases (two of which had a history of recurrent PAM with severe atypia) progressed to MM. The criteria for evaluation of atypia were found to be significantly associated with the clinical outcome (p < 0.0001). The standardised histological scoring protocol of MCL is reliable, and may reduce the risk of confusing a benign MCL, such as IJCN, with one that is potentially preneoplastic. It may also prove useful in predicting which PAM lesions will progress to MM.

Connection between uveal melanoma and dysplastic naevus syndrome

The dysplastic naevus syndrome increases the risk of cutaneous (RR: 4.36; CI: 1.84-10.36) as well as uveal melanoma (RR: 4.22; CI: 1.81-9.84). A significantly higher occurrence rate of conjunctival naevi (3.2% vs. 0%; p=0.029), choroidal naevi (5.2% vs. 0.7%; p=0.023) and iris freckles (17.1% vs. 5.6%; p=0.002) could be detected in the dysplastic naevus syndrome patients compared to subjects in the control group. The presence of cutaneous dysplastic naevi in uveal melanoma patients increases the risk of the prognostically worse--epitheloid or mixed--forms of uveal melanoma (RR: 5.97%; CI: 1.61-22.14), compared to patients without cutaneous atypical naevi.

Conjunctival naevi in Denmark 1960-1980. A 21-year follow-up study.

The clinicopathological characteristics of 343 naevi of the conjunctiva were studied. A significant increase in the number of naevi excised per annum was observed. This may have been caused by an increased exposure to actinic rays. Approximately even distribution in the three main locations: caruncle, limbal area and eyeball, was found. Intrastromal naevi were excised at a higher median age than compound naevi, and the lowest observed median age at excision was for junction naevi, which is in accordance with the known histopathological nature of naevi. Recurrence occurred in nine patients (2.7%), and one transformed to a malignant melanoma. Eight of the recurring naevi were located in the limbal area. Eight of the nine patients were women, suggesting hormonal factors as a possible cause. Recommendations for the handling of conjunctival naevi are given, based on the present findings and on previous reports.

Influence of cold ischemia time on outcome of human liver transplantation using UW solution

To develop a standardised protocol for grading atypia in melanocytic conjunctival lesions (MCL), mainly primary acquired melanosis (PAM) and inflamed juvenile conjunctival naevi (IJCN) and to establish prognostic parameters for progression to malignant melanoma (MM).A retrospective non-randomised study of 304 patients with MCL was conducted. Histological slides of MCL diagnosed as conjunctival naevus (CN; 222 cases), PAM (42 cases), and IJCN (40 cases) were reviewed. A scoring method of atypia was developed according to the following histological parameters: nest cohesion, melanocytic hyperplasia, nuclear features, and pagetoid spread. Lesions were scored according to the number of criteria as mild (1–2), moderate (3–4) and severe (5–8).Nineteen PAM lesions showed mild (n = 8), moderate (n = 4), and severe (n = 7) atypia. The remaining PAM lesions were without atypia. IJCN cases showed architectural disorder only. Neither architectural disorder nor cytological atypia were found in the CN. There were no recurrences in the IJCN and PAM lesions without and with mild atypia, while two PAM with moderate and two with severe atypia recurred. Three cases (two of which had a history of recurrent PAM with severe atypia) progressed to MM.The criteria for evaluation of atypia were found to be significantly associated with the clinical outcome (p < 0.0001).The standardised histological scoring protocol of MCL is reliable, and may reduce the risk of confusing a benign MCL, such as IJCN, with one that is potentially preneoplastic. It may also prove useful in predicting which PAM lesions will progress to MM.

Spontaneous cyclical pigmentary changes in a conjunctival naevus.

Spontaneous cyclical pigmentary changes in a conjunctival naevus.