Clinical Features Differentiating Benign From Malignant Conjunctival Tumors in Children

Area of Science:

• Ophthalmology
• Pediatric Oncology
• Dermatology

Background:

• Conjunctival tumors in pediatric populations are predominantly benign.
• Malignant conjunctival tumors in children are infrequent but require careful evaluation.

Purpose of the Study:

• To compare the clinical characteristics of benign and malignant conjunctival tumors in children.
• To identify features that may help differentiate between benign and malignant conjunctival lesions in pediatric patients.

Main Methods:

• Retrospective case series analysis of 806 pediatric conjunctival tumor cases (age <21 years) from a tertiary referral center (1975-2015).
• Comparison of demographic and tumor features between benign and malignant diagnoses.
• Statistical analysis to identify significant differences in presentation and characteristics.

Main Results:

• The vast majority (97%) of conjunctival tumors in children were benign; malignant tumors (3%) included melanoma and lymphoma.
• Malignant tumors were more common in older children (mean age 14 vs. 11 years).
• Melanoma showed increased association with older age (>10-15 years), larger tumor size, hemorrhage, and lack of cysts compared to nevi. Lymphoma presented with larger size and diffuse involvement compared to benign reactive lymphoid hyperplasia (BRLH).

Conclusions:

• Conjunctival tumors in children are overwhelmingly benign.
• Specific clinical features, such as age, tumor size, hemorrhage, and cyst presence, can aid in distinguishing malignant conjunctival tumors like melanoma and lymphoma from benign counterparts.
• Early identification of concerning features is crucial for timely diagnosis and management of rare malignant conjunctival tumors in children.