Infected epithelial inclusion cyst simulating conjunctival melanoma

Area of Science:

• Ophthalmology
• Dermatopathology
• Surgical Pathology

Background:

• Pigmented, nonneoplastic lesions can clinically mimic melanocytic tumors, posing diagnostic challenges.
• Distinguishing benign mimics from malignant neoplasms is crucial for appropriate patient management.

Observation:

• An unusual conjunctival epithelial inclusion cyst was identified.
• The cyst contained luminal bacterial colonies, hemorrhage, and epithelial debris.
• Clinically, the lesion convincingly simulated a melanoma.

Findings:

• Histopathological examination confirmed the diagnosis of an epithelial inclusion cyst.
• The presence of bacterial colonies, hemorrhage, and debris contributed to the cyst's pigmented and atypical clinical appearance.
• The lesion was benign, despite its melanoma-like presentation.

Implications:

• This case highlights the importance of histopathological correlation in diagnosing conjunctival lesions.
• Awareness of such unusual mimics can prevent misdiagnosis and unnecessary aggressive treatment for melanoma.
• Conjunctival cysts, though rare, should be considered in the differential diagnosis of pigmented conjunctival masses.