Spontaneous regression of a conjunctival naevus

Abstract

Conjunctival naevi are one of the most common lesions affecting the conjunctiva. While benign in the vast majority of cases, the risk of malignant transformation necessitates regular follow-up. They are well known to increase in size; however, we present the first photo-documented case of spontaneous regression of conjunctival naevus. In most cases, surgical excision is performed due to the clinician's concerns over malignancy. However, a substantial proportion of patients request excision. Highlighting the potential for regression of the lesion is important to ensure patients make an informed decision when contemplating such surgery.

Surgical treatment of conjunctival nevi in pediatric patients

“…According to various sources, cysts are identified in 60-70% of conjunctival lesions in adults and 65% in children (2,3,4). There seems to be an agreement that conjunctival lesions need to be monitored over time (5). According to Sayyad et al (6), the best method for monitoring conjunctival lesions is regular follow-up examination including photographs of the abnormal conjunctiva.…”

“…altered pigmentation, size and vascularisation) may indicate the onset of a malignant transformation. Malignancy may also manifest as late onset conjunctival pigmented lesions, lesions located in the tarsal conjunctiva and conjunctival fornix as well as the absence of cysts on the surface of the lesion (1,2,5,12). Monitoring a group of 410 patients with conjunctival pigmented lesions, Shield et al noticed an increase of lesion size in 7% of cases, its altered colour in 5% of cases, darkening of conjunctival lesions in 13% cases and lesion growth in 8% of cases (2).…”

“…Haldar et al (5) and Balaeva et al (13) state that changes in lesion colour and size are normal only during pregnancy and in children during the growth period. Therefore, physiology may hinder close monitoring of conjunctival lesions children, so it is an imperative for practitioners to follow-up the lesions regularly with particular caution.…”

“…Shields et al (2,3) analysed a group of 410 patients and described dark pigmented lesions (65% of cases), lightly coloured lesions (19%) and colourless nodules (16%). Several authors reported that conjunctival nevus is usually located in the bulbar conjunctiva and less frequently in the lacrimal caruncle, plica semilunaris or palpebral conjunctiva (1,2,4,5).…”

Regressing conjunctival nevus in a child

“…Spontaneous regression of conjunctival nevus in children is uncommon and has only been reported in one case before. [ 5 ] Herein, we report a case showing a drastic regression of a conjunctival nevus in a child.…”