Conjunctival melanomas harbor BRAF and NRAS mutations and copy number changes similar to cutaneous and mucosal

Klaus G Griewank1, Henrike Westekemper, Rajmohan Murali

  • 1Department of Dermatology, Institute of Pathology and Neuropathology, University Hospital, University Duisburg-Essen, Essen, Germany.

Abstract

Insights

Genetic analysis of conjunctival melanoma reveals BRAF and NRAS mutations in nearly half of cases. These findings suggest conjunctival melanoma is similar to cutaneous and mucosal melanoma, distinct from uveal melanoma.

Area of Science:

  • Ophthalmology
  • Oncology
  • Genetics

Background:

  • Conjunctival melanoma is a rare, aggressive eye tumor with frequent recurrence and metastasis.
  • Limited knowledge exists regarding the genetic alterations driving conjunctival melanoma.
  • Metastatic conjunctival melanoma has a poor prognosis and limited treatment options.

Purpose of the Study:

  • To investigate the genetic landscape of conjunctival melanomas.
  • To identify key genetic alterations and compare them to other melanoma subtypes.

Main Methods:

  • Genetic analysis of 78 conjunctival melanoma samples.
  • Oncogene hotspot array for known cancer mutations.
  • Genome-wide copy number alteration analysis.
  • Sanger sequencing for targeted mutations.

Main Results:

  • BRAF mutations found in 29% of tumors.
  • NRAS mutations, previously unrecognized, detected in 18% of tumors.
  • Copy number alterations showed patterns similar to cutaneous/mucosal melanoma, distinct from uveal melanoma.

Conclusions:

  • BRAF or NRAS mutations occur mutually exclusively in 47% of conjunctival melanomas.
  • Genetic profile supports a close relationship to cutaneous and mucosal melanoma, distinct from uveal melanoma.
  • Metastatic conjunctival melanoma patients may benefit from therapies used for cutaneous/mucosal melanoma.

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