Graphite foreign body of the conjunctiva simulating melanoma

Area of Science:

• Ophthalmology
• Pathology
• Traumatology

Background:

• Pigmented conjunctival lesions can present diagnostic challenges.
• Melanoma is a significant concern in the differential diagnosis of such lesions.
• Ocular trauma, including pencil injuries, can lead to unusual presentations.

Observation:

• A case report details a patient with a growing, vascular, pigmented conjunctival mass.
• The patient had a history of a pencil injury to the affected eye.
• The lesion's appearance raised suspicion for conjunctival melanoma.

Findings:

• Surgical excision of the conjunctival mass was performed.
• Histopathological examination revealed the lesion to be a graphite foreign body granuloma.
• The granuloma formation was attributed to the retained graphite from the previous injury.

Implications:

• Graphite foreign body granuloma should be included in the differential diagnosis of enlarging pigmented conjunctival masses.
• This case underscores the importance of a thorough patient history, including trauma, in diagnosing conjunctival lesions.
• Ophthalmologists should be aware of foreign body reactions to graphite, especially in cases of prior ocular injury.