Clinical and Histopathological Features of Corneal Primary Acquired Melanosis and Melanoma

Abstract

<b><i>Aim:</i></b> The aim of this study is to describe the clinical and pathologic features of corneal primary acquired melanosis (PAM) and melanoma. <b><i>Methods:</i></b> We describe 3 cases in total: two cases of corneal melanomas and 1 case of corneal PAM. The eyes were processed routinely for histopathological examination. Clinical histories, treatments, and outcomes were reviewed. <b><i>Results:</i></b> Corneal melanomas arose from recurrence of conjunctival melanoma or conjunctival PAM at the limbus. One patient had a recurrence after excision of a limbal melanoma, another had a de novo corneal melanoma, and the last patient had corneal PAM in the setting of conjunctival PAM with atypia. All lesions were excised with adjuvant alcohol debridement and cryotherapy with no recurrence ranging from 1 week to 8 years. <b><i>Conclusions:</i></b> Corneal melanomas arise at the limbus from corneal PAM or conjunctival atypia. They can appear after excisional removal of a conjunctival melanoma. Surgical excision with alcohol debridement and adjuvant cryotherapy is successful.

Primary Sites and Clinicopathological Features of Corneal Melanoma: A SEER Population-Based Study of 29 Cases

“…This technique yielded favorable outcomes and a close nine-year follow-up period showed no recurrence in one recorded case of corneal melanoma. 2 In another case, feeder vessels were cauterized before the lesion was removed on free margins then the corneal epithelial was scraped.…”

“…Therapeutic management in several case studies included surgical excision. [1][2][3][4] In a study describing corneal primary acquired melanosis, recommended treatment was to do a complete excision with alcohol debridement of Bowman's later. After excision, adjuvant double freeze-thaw cryotherapy was performed on adjacent conjunctiva free margins.…”

“…The following inclusion criteria was applied to the patient cohort for this study: (1) Patients distinguished with primary malignancy from 1983 to 2018 were reviewed; (2) The diagnoses for all cases in the cohort were established during the patients' lifetime, with exclusion criteria speci cally omitting cases involving death certi cates or autopsies; (3) Morphology codes de ned by the international classi cation of diseases for oncology (ICD-O-3); (4) Primary Site Extent of Disease Data coded to the Cornea (C691); (5) Not otherwise speci ed Histology Terms and Codes for Melanoma in situ (8720/2). After isolating cases matching the speci ed inclusion criteria, 24 malignant melanomas (Not Otherwise Speci ed (NOS)), 1 super cial spreading melanoma, 2 Spindle cell melanomas, 1 Nodular melanoma, and 1 epithelioid cell melanoma were identi ed.…”

“…Surgical excision, cryotherapy, and topical chemotherapy followed by steroid and antibiotic medicine have been described to have a good prognosis. 1,2 However, there is a need for tailored treatment approaches for speci c histologic subtypes.…”

“…Migrating melanocytes can then invade corneal stroma by way of penetrating traumas or complicated surgeries to in ltrate Bowman's membrane. 2 CM is incredibly rare and has yet to be summarized beyond a case study setting. A deeper understanding of the disease pathology and prognosis is necessary to better treat future patients.…”