Related Experiment Video
Updated: Jul 5, 2026
Implantation and Evaluation of Melanoma in the Murine Choroid via Optical Coherence Tomography
Published on: December 2, 2022
Primary acquired melanosis of the conjunctiva: experience with 311 eyes
Jerry A Shields1, Carol L Shields, Arman Mashayekhi
1Oncology Service, Wills Eye Institute, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Purpose:
To evaluate clinical features and risks for transformation of conjunctival primary acquired melanosis (PAM) into melanoma.
Methods:
Retrospective chart review and Kaplan-Meier estimates of times to PAM enlargement, recurrence, and transformation into melanoma.
Main Outcome Measures:
PAM enlargement, recurrence, and transformation into melanoma.
Results:
The mean patient age at diagnosis of PAM was 56 years; 62% were female and 96% Caucasian. The conjunctival quadrant(s) affected by PAM and its extent in clock hours were recorded. Initial management included observation in 62%, biopsy combined with cryotherapy in 34%, and other methods in 4%. Of PAM that was observed, Kaplan-Meier estimates at 10 years revealed PAM enlargement in 35% and transformation into melanoma in 12%. Of those that underwent incisional or excisional biopsy, 10-year estimates of PAM recurrence and transformation into melanoma were 58% and 11%, respectively. Progression to melanoma occurred in 0% of PAM without atypia, 0% of PAM with mild atypia, and 13% of PAM with severe atypia. Multivariable analysis revealed that the most significant factor for both PAM recurrence and progression to melanoma was extent of PAM in clock hours.
Conclusion:
PAM without atypia or with mild atypia shows 0% progression into melanoma, whereas PAM with severe atypia shows progression into melanoma in 13%. The greater the extent of PAM in clock hours, the greater the risk for transformation into melanoma.
Insights
Conjunctival primary acquired melanosis (PAM) with severe atypia has a 13% melanoma transformation risk. Larger PAM extent increases recurrence and melanoma risk.
Area of Science:
- Ophthalmology
- Dermatology
- Oncology
Background:
- Conjunctival primary acquired melanosis (PAM) is a potentially precancerous lesion.
- Understanding risk factors for PAM transformation into melanoma is crucial for patient management.
Purpose of the Study:
- To evaluate clinical features and transformation risks of conjunctival primary acquired melanosis (PAM) into melanoma.
- To identify key indicators for PAM progression.
Main Methods:
- Retrospective chart review of conjunctival primary acquired melanosis (PAM) cases.
- Kaplan-Meier analysis to estimate times to PAM enlargement, recurrence, and melanoma transformation.
- Multivariable analysis to identify significant risk factors.
Main Results:
- Mean patient age was 56 years; 62% female, 96% Caucasian.
- 10-year estimates: 35% PAM enlargement, 12% transformation to melanoma with observation; 58% recurrence, 11% transformation with biopsy/cryotherapy.
- Progression to melanoma: 0% for PAM without/mild atypia, 13% for PAM with severe atypia.
- Extent of PAM in clock hours was the most significant factor for recurrence and melanoma progression.
Conclusions:
- Conjunctival primary acquired melanosis (PAM) without or with mild atypia has a 0% progression rate to melanoma.
- PAM with severe atypia shows a 13% risk of transformation into melanoma.
- Increased extent of PAM correlates with higher risks of recurrence and melanoma transformation.
More Related Videos
Related Concept Videos
01:22Microbiome of the Eye
01:30Skin Cancer
Basal Cell Carcinoma (BCC): BCC is the most common type of skin cancer, accounting for about 80% of cases. It typically develops in...
01:25Glaucoma: Overview