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Clinical and Histopathological Features of Corneal Primary Acquired Melanosis and Melanoma
Aaron Yeung1, Ogul E Uner2, Jill R Wells1
1Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA.
Aim:
The aim of this study is to describe the clinical and pathologic features of corneal primary acquired melanosis (PAM) and melanoma.
Methods:
We describe 3 cases in total: two cases of corneal melanomas and 1 case of corneal PAM. The eyes were processed routinely for histopathological examination. Clinical histories, treatments, and outcomes were reviewed.
Results:
Corneal melanomas arose from recurrence of conjunctival melanoma or conjunctival PAM at the limbus. One patient had a recurrence after excision of a limbal melanoma, another had a de novo corneal melanoma, and the last patient had corneal PAM in the setting of conjunctival PAM with atypia. All lesions were excised with adjuvant alcohol debridement and cryotherapy with no recurrence ranging from 1 week to 8 years.
Conclusions:
Corneal melanomas arise at the limbus from corneal PAM or conjunctival atypia. They can appear after excisional removal of a conjunctival melanoma. Surgical excision with alcohol debridement and adjuvant cryotherapy is successful.
Insights
Corneal melanomas, rare eye cancers, can develop from primary acquired melanosis (PAM) of the cornea. Surgical excision with alcohol debridement and cryotherapy shows successful outcomes in treating these limbal tumors.
Area of Science:
- Ophthalmology
- Oncology
- Pathology
Background:
- Primary acquired melanosis (PAM) is a rare condition that can affect the cornea.
- Corneal melanoma is an even rarer malignancy that can arise from PAM or conjunctival atypia.
Purpose of the Study:
- To describe the clinical and pathologic features of corneal primary acquired melanosis (PAM) and melanoma.
- To evaluate treatment outcomes for these rare corneal conditions.
Main Methods:
- Retrospective review of 3 cases: 2 corneal melanomas and 1 corneal PAM.
- Histopathological examination of excised ocular tissues.
- Review of clinical histories, treatments, and patient outcomes.
Main Results:
- Corneal melanomas originated at the limbus, either as recurrences of conjunctival melanoma/PAM or de novo.
- One case involved corneal PAM in the context of conjunctival PAM with atypia.
- All lesions were surgically excised with adjuvant alcohol debridement and cryotherapy, with no recurrences observed during follow-up periods ranging from 1 week to 8 years.
Conclusions:
- Corneal melanomas typically arise at the limbus from corneal PAM or conjunctival atypia.
- Recurrence after conjunctival melanoma excision is possible.
- Surgical excision combined with alcohol debridement and cryotherapy is an effective treatment strategy.
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